Organization Active NPI

Jennifer Upchurch LCSW PLLC

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1265016422
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
JENNIFER UPCHURCH LCSW PLLC
Practice address
7741 Market St Ste a
Wilmington, NC 28411-9444
Phone
(910) 228-8522
NPI assigned
May 12, 2021
Last updated
May 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Authorized official

Name
Jennifer Upchurch, LCSWNPI 1023109337
Title
Owner
Phone
(910) 228-8522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

7741 Market St Ste a
Wilmington, NC 28411-9444

Mailing address

7741 Market St Ste a
Wilmington, NC 28411-9444
Phone (910) 228-8522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210701000080 NC Part B Supplier - Clinic/Group Practice 8325449036 Receives reassigned benefits from 1 practitioner
Practice locations: Wilmington, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1265016422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7741 MARKET ST STE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284119444",
            "telephone_number": "910-228-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7741 MARKET ST STE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284119444",
            "telephone_number": "910-228-8522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER UPCHURCH LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "UPCHURCH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-228-8522",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.