Vernon Internal Medicine Clinic Inc

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

Legal business name

VERNON INTERNAL MEDICINE CLINIC INC

Practice address

931 Verone Ter
Suite a
Leesville, LA 71446-4272

Phone

(337) 238-3475

Fax

(337) 238-3475

NPI assigned

Jul 7, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kanchan Prasad Upadhyay, MDNPI 1265463061

Title

Buisness Owner

Phone

(337) 238-3475

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kanchan Prasad Upadhyay, MD

  • Hematology & Oncology Physician
  • Leesville, LA
  • NPI 1265463061
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583798400000",
    "number": "1306878350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 VERONE TER",
            "address_2": "SUITE A",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464272",
            "telephone_number": "337-238-3475",
            "fax_number": "337-238-3475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 VERONE TER",
            "address_2": "SUITE A",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464272",
            "telephone_number": "337-238-3475",
            "fax_number": "337-238-3475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERNON INTERNAL MEDICINE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A",
        "authorized_official_last_name": "UPADHYAY",
        "authorized_official_first_name": "KANCHAN",
        "authorized_official_middle_name": "PRASAD",
        "authorized_official_title_or_position": "BUISNESS OWNER",
        "authorized_official_telephone_number": "337-238-3475",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578924",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHEILD",
            "identifier": "0508695280",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "36-00370",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Veillion, RBT
• Manguesh G Velingker
• Vernon Community Counseling Services, LLC
• Vernon Council on Aging, Inc.
• Vernon Home Health Inc
• Vernon Investment Group, LLC
• Vernon Medical Care LLC
• Vernon MHT LLC
• Vernon Parish Community Health Center Pharmacy
• Vernon Parish School Board

• Hematology & Oncology Physician in Leesville, LA
• Providers in Leesville, LA by specialty
• Hematology & Oncology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.