Active NPI
Krystal Dawn Upshaw, DPM
- Podiatrist
- Corning, AR
National Provider Identifier
1285046896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 272
- Practice address
- 1300 Creason Rd
Corning, AR 72422 - Phone
- (870) 857-3399
- Fax
- (870) 857-3301
- NPI assigned
- Jun 2, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 272 | AR | Primary |
Addresses
Primary practice location
1300 Creason Rd
Corning, AR 72422
Mailing address
PO Box 83
Corning, AR 72422-0083
Phone (870) 857-3334
Other practice location 1
2801 Medical Center Dr
Pocahontas, AR 72455-9436
Phone (870) 892-6000
Other practice location 2
1 Medical Dr
Paragould, AR 72450-4017
Phone (870) 236-2000
Other practice location 3
172 Highway 62 W
Salem, AR 72576-8059
Phone (870) 895-2735
Other practice location 4
308 Highway 62 W
Ash Flat, AR 72513-9415
Phone (870) 994-2202
Other practice location 5
201 Colonial Dr
Walnut Ridge, AR 72476-1410
Phone (870) 886-5507
Other practice location 6
141 Betty Dr
Pocahontas, AR 72455-3602
Phone (870) 892-9949
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 224176717 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lawrence Memorial Health Foundation Inc. | Current | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
1309 W Main St
Walnut Ridge, AR 72476
Phone (870) 886-1200
Organizations & group practices 3
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.
-
- Rural Health Clinic/Center
- Walnut Ridge, AR
- NPI 1528052107
-
- Critical Access Hospital
- Walnut Ridge, AR
- NPI 1962626770
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556755200000",
"number": "1285046896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 83",
"city": "CORNING",
"state": "AR",
"postal_code": "724220083",
"telephone_number": "870-857-3334",
"fax_number": "870-857-9934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 CREASON RD",
"city": "CORNING",
"state": "AR",
"postal_code": "72422",
"telephone_number": "870-857-3399",
"fax_number": "870-857-3301"
}
],
"practiceLocations": [
{
"address_1": "2801 Medical Center Dr",
"address_purpose": "LOCATION",
"city": "Pocahontas",
"state": "AR",
"postal_code": "724559436",
"country_code": "US",
"telephone_number": "870-892-6000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Medical Dr",
"address_purpose": "LOCATION",
"city": "Paragould",
"state": "AR",
"postal_code": "724504017",
"country_code": "US",
"telephone_number": "870-236-2000",
"fax_number": "870-236-5861",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "172 Highway 62 W",
"address_purpose": "LOCATION",
"city": "Salem",
"state": "AR",
"postal_code": "725768059",
"country_code": "US",
"telephone_number": "870-895-2735",
"fax_number": "870-895-2709",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "308 Highway 62 W",
"address_purpose": "LOCATION",
"city": "Ash Flat",
"state": "AR",
"postal_code": "725139415",
"country_code": "US",
"telephone_number": "870-994-2202",
"fax_number": "870-994-2328",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "201 Colonial Dr",
"address_purpose": "LOCATION",
"city": "Walnut Ridge",
"state": "AR",
"postal_code": "724761410",
"country_code": "US",
"telephone_number": "870-886-5507",
"fax_number": "870-886-5632",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "141 Betty Dr",
"address_purpose": "LOCATION",
"city": "Pocahontas",
"state": "AR",
"postal_code": "724553602",
"country_code": "US",
"telephone_number": "870-892-9949",
"fax_number": "870-892-0208",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "UPSHAW",
"first_name": "KRYSTAL",
"middle_name": "DAWN",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-02",
"last_updated": "2019-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "AR",
"license": "272",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "224176717",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Corning, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.