Agnes Pamela Upchurch, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R797137 Issued in MS

Practice address

1350 Sunset Dr
Ste B
Grenada, MS 38901-4079

Phone

(662) 229-0669

Fax

(662) 227-9929

NPI assigned

Aug 17, 2009

Last updated

Feb 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Mississippi Medical Center- Grenada Hospital, Grenada, MS, CCN 250168

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• H & P Investors, LLC

  dba Mediquik Clinic

  • Family Medicine Physician
  • Grenada, MS
  • NPI 1902010218
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• State of Mississippi-University of Mississippi Medical Center

  dba University of Mississippi Center - Grenada Psych

  • Psychiatric Hospital
  • Grenada, MS
  • NPI 1083041917
  Care Compare affiliation
• State of Mississippi-University of Mississippi Medical Center

  dba University of Mississippi Center-Grenada

  • General Acute Care Hospital
  • Grenada, MS
  • NPI 1558798603
  Care Compare affiliation

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1063644599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 SUNSET DR",
            "address_2": "STE B",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014079",
            "telephone_number": "662-229-0669",
            "fax_number": "662-227-9929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 SUNSET DR",
            "address_2": "STE B",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014079",
            "telephone_number": "662-229-0669",
            "fax_number": "662-227-9929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPCHURCH",
        "first_name": "AGNES",
        "middle_name": "PAMELA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-17",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R797137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Premier Center LLC
• The Smile Center Inc (The Smile Center)
• TKB MCC
• Ronnie Tritt, FNP-BC
• Triumph Prosperity, LLC (Triumph Prosperity Transportation)
• Olivia McDaniel Van Gordon
• Michelle Vanhorn, RPH
• Vascular and Vein Institute of the South, PLLC
• Jeremy Villalobos
• Viner Counseling Center

• Family Nurse Practitioner in Grenada, MS
• Providers in Grenada, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.

Verify at the official NPI Registry.