Individual provider Active NPI

Greg C Upham Jr., PHARMD

  • Pharmacist
  • Memphis, TN
National Provider Identifier
1659501245
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
33570 Issued in TN
Practice address
8700 W Trail Lake Dr Ste 205
Memphis, TN 38125-8205
Phone
(423) 276-4642
NPI assigned
Jul 17, 2009
Last updated
Dec 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202210507 VA
Pharmacist 183500000X PS0044823 FL
Pharmacist 183500000X 33570 TN Primary

Addresses

Primary practice location

8700 W Trail Lake Dr Ste 205
Memphis, TN 38125-8205

Mailing address

8700 W Trail Lake Dr Ste 205
Memphis, TN 38125-8205
Phone (901) 309-1404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS0044823FLMDPharmacist
33570TNMDPharmacist
0202210507VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Feb 24, 2022 Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1659501245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 W TRAIL LAKE DR STE 205",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258205",
            "telephone_number": "901-309-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 W TRAIL LAKE DR STE 205",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258205",
            "telephone_number": "423-276-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPHAM",
        "first_name": "GREG",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-17",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202210507",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS0044823",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "33570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.