Active NPI
Brent H Upchurch, MD
- Pediatrics Physician
- N Easton, MA
National Provider Identifier
1174505457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 59406
- Practice address
- 31 Roche Brothers Way
TWP, Suite 140
N Easton, MA 02767 - Phone
- (508) 894-0400
- Fax
- (508) 894-0332
- NPI assigned
- Nov 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 59406 | MA | Primary |
Addresses
Primary practice location
31 Roche Brothers Way
TWP, Suite 140
N Easton, MA 02767
Mailing address
680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7885
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3092411 | Medicaid | MA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59406 | MA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382054400000",
"number": "1174505457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "680 CENTRE ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023023308",
"telephone_number": "508-941-7885",
"fax_number": "508-947-6337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31 ROCHE BROTHERS WAY",
"address_2": "TWP, SUITE 140",
"city": "N EASTON",
"state": "MA",
"postal_code": "02767",
"telephone_number": "508-894-0400",
"fax_number": "508-894-0332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UPCHURCH",
"first_name": "BRENT",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-14",
"last_updated": "2013-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "59406",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3092411",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in N Easton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.