Individual provider Active NPI

James David Upchurch

  • Family Medicine Physician
  • Crow Agency, MT
National Provider Identifier
1992719462
Registry record updated Mar 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6088 Issued in MT
Practice address
10110 S 7650 E
Crow Northern Cheyenne Indian Hospital
Crow Agency, MT 59022
Phone
(406) 638-3442
Fax
(406) 638-3482
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6088 MT Primary

Addresses

Primary practice location

10110 S 7650 E
Crow Northern Cheyenne Indian Hospital
Crow Agency, MT 59022

Mailing address

HC 36 Box 2010
Peritsa Creek Rd
Hardin, MT 59034
Phone (406) 638-3442

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20151211001281 MT Practitioner - Family PracticePractitioner - Geriatric Medicine 0547164675 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6088MTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Big Horn Hospital Association CurrentSince Dec 1, 2015 Accepting new patients
Big Horn Hospital Association CurrentSince Dec 1, 2015 Accepting new patients
US Dept of HHS Family Medicine Past Accepting new patients

Locations

17 N Miles Ave
Hardin, MT 59034
Phone (406) 665-2310

Organizations & group practices 3

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362700800000",
    "number": "1992719462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 36 BOX 2010",
            "address_2": "PERITSA CREEK RD",
            "city": "HARDIN",
            "state": "MT",
            "postal_code": "59034",
            "telephone_number": "406-638-3442",
            "fax_number": "406-638-3482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10110 S 7650 E",
            "address_2": "CROW NORTHERN CHEYENNE INDIAN HOSPITAL",
            "city": "CROW AGENCY",
            "state": "MT",
            "postal_code": "59022",
            "telephone_number": "406-638-3442",
            "fax_number": "406-638-3482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPCHURCH",
        "first_name": "JAMES",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2013-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "6088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crow Agency, MT

Sources for this page

Verify at the official NPI Registry.