Individual provider Active NPI

Matthew Ryan Upchurch, DC

  • Chiropractor
  • La Jolla, CA
National Provider Identifier
1750984068
Registry record updated Nov 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
34941 Issued in CA
Practice address
8950 Villa la Jolla Dr Ste B212
La Jolla, CA 92037-1708
Phone
(858) 588-3111
NPI assigned
Nov 18, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 34941 CA Primary

Addresses

Primary practice location

8950 Villa la Jolla Dr Ste B212
La Jolla, CA 92037-1708

Mailing address

2893 McGraw St
San Diego, CA 92117-6044
Phone (619) 381-3759

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210111001796 CA Practitioner - Chiropractic 3072926260

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2893 McGraw St
San Diego, CA 92117-6044

4901 Morena Blvd
Suite 209a
San Diego, CA 92117-3300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Upchurch Chiropractic Inc Chiropractor CurrentSince Jan 15, 2021 Accepting new patients

Locations

8950 Villa La Jolla Dr
Ste B212
La Jolla, CA 92037
Phone (858) 450-6947

4901 Morena Blvd
Ste 209A
San Diego, CA 92117
Phone (480) 628-0483

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606003200000",
    "number": "1750984068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2893 MCGRAW ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176044",
            "telephone_number": "619-381-3759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 VILLA LA JOLLA DR STE B212",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371708",
            "telephone_number": "858-588-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPCHURCH",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-22",
        "certification_date": "2020-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "34941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2020; 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.