Active NPI
Dallas Leigh Upchurch, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Temple, TX
National Provider Identifier
1013551233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 10009760
- Practice address
- 1901 Veterans Memorial Dr
Temple, TX 76504-7451 - Phone
- (254) 778-4811
- NPI assigned
- Oct 30, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 10009760 | OR | Primary |
| Nurse Practitioner | 363L00000X | 10009760 | OR |
Addresses
Primary practice location
1901 Veterans Memorial Dr
Temple, TX 76504-7451
Mailing address
821 Kendra Dr
Temple, TX 76502-5878
Phone (706) 326-6088
Other practice location 1
5441 S.Maccadan Ave 8160
Portland, OR 97239
Phone (917) 265-9614
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2 Brighton Rd
Suite 300
Clifton, NJ 07012-1645
5441 S Maccadan Ave
Suite 8160
Portland, OR 97239
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10009760 | OR | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeside Serenity Psychiatry, LLC | Current | Accepting new patients | |
| Psychlife Mental Wellness LLC | Psychiatric/Mental Health | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatry Physician
- Portland, OR
- NPI 1366308785
-
- Psychiatric/Mental Health Nurse Practitioner
- Dallas, TX
- NPI 1245945682
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774224000000",
"number": "1013551233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "821 KENDRA DR",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765025878",
"telephone_number": "706-326-6088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 VETERANS MEMORIAL DR",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765047451",
"telephone_number": "254-778-4811"
}
],
"practiceLocations": [
{
"address_1": "5441 S.Maccadan Ave 8160",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "97239",
"country_code": "US",
"telephone_number": "917-265-9614",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "UPCHURCH",
"first_name": "DALLAS",
"middle_name": "LEIGH",
"credential": "PMHNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-30",
"last_updated": "2026-03-23",
"certification_date": "2026-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": "10009760",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OR",
"license": "10009760",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.