Individual provider Active NPI

Thomas A Upshaw, M.D.

  • Psychiatry Physician
  • Mount Pleasant, SC
National Provider Identifier
1306002142
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
18101 Issued in SC
Practice address
728 S Shelmore Blvd Ste 103
Mount Pleasant, SC 29464-1601
Phone
(843) 972-0262
Fax
(843) 972-0263
NPI assigned
Jul 31, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 18101 SC Primary

Addresses

Primary practice location

728 S Shelmore Blvd Ste 103
Mount Pleasant, SC 29464-1601

Mailing address

728 S Shelmore Blvd Ste 103
Mount Pleasant, SC 29464-1601
Phone (843) 972-0262

Other identifiers 1

IdentifierTypeStateIssuer
181010MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address thomasupshawMD@TAUM-SC.direct.office.nextgen.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20040726000681 SC Practitioner - Psychiatry 4082694328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Emory University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

728 S Shelmore Blvd
Suite 103
Mount Pleasant, SC 29464-1601

Hospital & facility affiliations

  • Amedisys Hospice of South Carolina Hospice, Florence, SC, CCN 421555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18101SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas a Upshaw, MD, PA CurrentSince Apr 1, 2002 Accepting new patients

Locations

728 S Shelmore Blvd
Ste 103
Mt Pleasant, SC 29464
Phone (843) 972-0262

1470 Ben Sawyer Blvd
Ste 17
Mt Pleasant, SC 29464

921 Bowman Rd
Mt Pleasant, SC 29464
Phone (843) 375-2901

Interoperability endpoints

  • Direct secure messaging: thomasupshawmd@taum-sc.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1306002142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 S SHELMORE BLVD STE 103",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294641601",
            "telephone_number": "843-972-0262",
            "fax_number": "843-972-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 S SHELMORE BLVD STE 103",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294641601",
            "telephone_number": "843-972-0262",
            "fax_number": "843-972-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPSHAW",
        "first_name": "THOMAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-31",
        "last_updated": "2023-09-18",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "18101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181010",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thomasupshawMD@TAUM-SC.direct.office.nextgen.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "728 S Shelmore Blvd Ste 103",
            "city": "Mount Pleasant",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294641601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.