Individual provider Active NPI

Nina Sofia Upham, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Vancouver, WA
National Provider Identifier
1043483043
Registry record updated Jan 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
60278739 Issued in WA
Practice address
2525 NE 139TH St
Vancouver, WA 98686-2719
Phone
(360) 882-2778
NPI assigned
Apr 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 60278739 WA Primary
Sports Medicine (Internal Medicine) Physician 207RS0010X MD60278739 WA

Addresses

Primary practice location

2525 NE 139TH St
Vancouver, WA 98686-2719

Mailing address

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

Other names 1

  • Dr. Nina Sofia Karjalainen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121016000695 WA Practitioner - Sports Medicine 6002066602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

2525 NE 139TH St
Vancouver, WA 98686-2719
Phone (360) 882-2778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60278739WAMDSports Medicine (Family Medicine) Physician
MD60278739WAMDSports Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Sep 4, 2012 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Sep 4, 2012 Accepting new patients

Locations

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

700 NE 87th Ave
Ste 370
Vancouver, WA 98664
Phone (360) 397-3352

2525 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1500

Interoperability endpoints

  • Direct secure messaging: nupham6832@tvc-direct.org

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358812800000",
    "number": "1043483043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641913",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NE 139TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862719",
            "telephone_number": "360-882-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPHAM",
        "first_name": "NINA",
        "middle_name": "SOFIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2013-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WA",
            "license": "60278739",
            "primary": true
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "WA",
            "license": "MD60278739",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NINA",
            "last_name": "KARJALAINEN",
            "middle_name": "SOFIA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.