Individual provider Active NPI

Maurice Upshaw Jr.

  • Specialist
  • Oklahoma City, OK
National Provider Identifier
1992017420
Registry record updated Jul 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
3035 NW 63Rd St Ste 201N
Oklahoma City, OK 73116-3606
Phone
(405) 842-8801
NPI assigned
Jul 13, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

3035 NW 63Rd St Ste 201N
Oklahoma City, OK 73116-3606

Mailing address

4641 Woodland Blvd Apt 217
Oklahoma City, OK 73105-6830
Phone (405) 824-3358

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

Practice roles

OrganizationSpecialtyStatusNew patients
Youthcare of Oklahoma Past Accepting new patients

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": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278979200000",
    "number": "1992017420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 WOODLAND BLVD APT 217",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731056830",
            "telephone_number": "405-824-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 NW 63RD ST STE 201N",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731163606",
            "telephone_number": "405-842-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPSHAW",
        "first_name": "MAURICE",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-13",
        "last_updated": "2010-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.