Phillip Upham V

Primary specialty

Social WorkerTaxonomy code 104100000X

License

I-1756 Issued in NM

Practice address

2040 W Main St
Ste 210-2422
Rapid City, SD 57702-0904

Phone

(505) 832-5817

Fax

(505) 832-5918

NPI assigned

Apr 26, 2007

Last updated

Mar 8, 2010By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268006400000",
    "number": "1639399074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 W MAIN ST,",
            "address_2": "SUITE 210-2422",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577022570",
            "telephone_number": "505-832-5918",
            "fax_number": "505-832-5918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 W MAIN ST",
            "address_2": "STE 210-2422",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577020904",
            "telephone_number": "505-832-5817",
            "fax_number": "505-832-5918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPHAM",
        "first_name": "PHILLIP",
        "name_suffix": "V",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2010-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "I-1756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Unkenholz Family Dental, Prof LLC
• Unkenholz Family Dental, Prof LLC (Family Dental Care by Unkenholz Family Dental)
• Unkenholz Omaha St Dental LLC (Family Dental Care)
• Eric Grant Unkenholz, DDS
• Shelbie Suzanne Unrein, RDN
• Luanne Uriel, CNM/ARNP
• Urological Clinic of Rapid City, P.C.
• Usv Optical Inc.
• Dawn P Utzman, CNP
• Luis Valadez

• Social Worker in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Social Worker in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.