Blaine G Upham, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

584 Issued in AK

Practice address

5461 E Mayflower LN Ste 6
Wasilla, AK 99654-7892

Phone

(907) 357-6688

Fax

(907) 357-9655

NPI assigned

Feb 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

ChiropracticAlso: Physical Medicine and Rehabilitation

Education

Other, 1994

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• 1632 E Cottonwood St Units a & B LLC

  • Chiropractor
  • Cottonwood, AZ
  • NPI 1992671663
  NPD Authorized official
• Mountain View Chiropractic

  • Chiropractor
  • Wasilla, AK
  • NPI 1083733737
  NPD (past)
• Premier Chiropractic 5 PLLC

  • Chiropractor
  • Seattle, WA
  • NPI 1851583348
  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1891838801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5461 E MAYFLOWER LN STE 6",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547892",
            "telephone_number": "907-357-6688",
            "fax_number": "907-357-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5461 E MAYFLOWER LN STE 6",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547892",
            "telephone_number": "907-357-6688",
            "fax_number": "907-357-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPHAM",
        "first_name": "BLAINE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5347",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelbie U'Ren
• Andrew J. Ulman
• Zoey Ulrick
• Christa Underwood, MPC
• Upekkha Wellness, LLC
• Lonnie Urban, LMT
• Urgent Care at Lake Lucille Inc
• Marc Uscola
• Utopia LLC
• John F. Vachal, P.T.

• Chiropractor in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Chiropractor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; 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.