Active NPI
Jerome J Upchurch, SA-C, CSFA
- Surgical Physician Assistant
- North Potomac, MD
National Provider Identifier
1023557618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- Practice address
- 15811 Chagall Ter
North Potomac, MD 20878-3461 - Phone
- (215) 518-2138
- NPI assigned
- Feb 16, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | |||
| Surgical Physician Assistant | 363AS0400X | Primary |
Addresses
Primary practice location
15811 Chagall Ter
North Potomac, MD 20878-3461
Mailing address
15811 Chagall Ter
North Potomac, MD 20878-3461
Phone (215) 518-2138
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surgical Focus LLC | Multi-Specialty | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536710400000",
"number": "1023557618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15811 CHAGALL TER",
"city": "NORTH POTOMAC",
"state": "MD",
"postal_code": "208783461",
"telephone_number": "215-518-2138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15811 CHAGALL TER",
"city": "NORTH POTOMAC",
"state": "MD",
"postal_code": "208783461",
"telephone_number": "215-518-2138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UPCHURCH",
"first_name": "JEROME",
"middle_name": "J",
"credential": "SA-C, CSFA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-16",
"last_updated": "2018-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Potomac, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.