Haley Dickerson Upchurch

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5017599 Issued in NC

Practice address

3485 N Main St
Farmville, NC 27828-1466

Phone

(252) 753-3193

NPI assigned

Feb 2, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Farmville Internal Medicine PAGroup PAC ID 8325037575, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: haley.upchurch.1@32498.direct.athenahealth.com

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.

• Farmville Internal Medicine PA

  • Family Medicine Physician
  • Farmville, NC
  • NPI 1710942610
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1598461386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4366 NC HIGHWAY 39 S",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275498692",
            "telephone_number": "919-729-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 N MAIN ST",
            "city": "FARMVILLE",
            "state": "NC",
            "postal_code": "278281466",
            "telephone_number": "252-753-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPCHURCH",
        "first_name": "HALEY",
        "middle_name": "DICKERSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5017599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Craig Smith, DDS
• Success Dynamics Community Development Corporation
• Together We Can Home Care
• Scott Christopher Troutman, PHARM.D.
• United Rehab Inc.
• Uplift Therapeutic Services Inc
• Walker Ventures, Inc. Dba Chiro1Source
• Cecil Murray Walker III, D.C.
• Bert Barrow Warren Jr., D.D.S.
• Bert Barrow Warren Sr., D.D.S.

• Nurse Practitioner in Farmville, NC
• Providers in Farmville, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.
• 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.