Faith Family Walk in Clinic LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

FAITH FAMILY WALK IN CLINIC LLC

Practice address

2095 Saint John Ave
Dyersburg, TN 38024-2209

Phone

(731) 445-5039

NPI assigned

Feb 21, 2025

Last updated

Jul 8, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angela Upchurch, FNPNPI 1275033888

Title

Family Nurse Practitioner

Phone

(731) 334-5353

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BAHIDD

Practitioners 3

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.

• Angela Dawn Upchurch, NP-C

  • Family Medicine Physician
  • Dyersburg, TN
  • NPI 1275033888
  Medicare reassignment Care Compare group NPD Authorized official
• Bradley Edward Gatlin

  • Family Nurse Practitioner
  • Dyersburg, TN
  • NPI 1225757008
  Medicare reassignment Care Compare group NPD
• Amber Ann Marie Sullivan, FNP-BC

  • Family Nurse Practitioner
  • Dyersburg, TN
  • NPI 1467158105
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1740096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751932800000",
    "number": "1508662354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2095 SAINT JOHN AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242209",
            "telephone_number": "731-334-5353",
            "fax_number": "731-334-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 SAINT JOHN AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242209",
            "telephone_number": "731-445-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH FAMILY WALK IN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A",
        "authorized_official_last_name": "UPCHURCH",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "731-334-5353",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• General Practice Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.