MR. JUSTIN MICHAEL UPHOLD (NPI# 1326504150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326504150 |
| Entity Type | Individual |
| Full Name | MR. JUSTIN MICHAEL UPHOLD |
| Credential | LPN |
| Practice Address |
620 Gallatin Pike S Madison TN 37115-4013 |
| Practice Telephone | 6154604300 |
| Mailing Telephone | 6154604300 |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2019-02-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | LPN0000091325 | TN | Nursing Service Providers |
| Street Address |
620 GALLATIN PIKE S |
| City | MADISON |
| State | TN |
| Zip Code | 37115-4013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316926553 | Sue St Clair | Nurse Practitioner | 620 Gallatin Pike S, Suite 214, Madison, TN 37115-4013 | 2006-01-16 |
| 1356960124 | Victoria Ann Fung-a-fat | Pharmacist | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2020-04-13 |
| 1962035915 | Olga Olivia Stanfill | Case Manager/Care Coordinator | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2020-02-18 |
| 1669010286 | Jennifer Janel Gardner | Licensed Practical Nurse | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2019-12-13 |
| 1619511417 | Andrea Santa Maria | Counselor | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2019-11-05 |
| 1871135921 | Jordann Moore | Case Manager/Care Coordinator | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2019-10-10 |
| 1386293546 | Stacy Hansen | Technician | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2019-09-10 |
| 1528617255 | Melba Buchanan | Counselor | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2019-09-05 |
| 1225686850 | Amy Jo Doiel | Case Manager/Care Coordinator | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2019-08-27 |
| 1023676624 | Ann Larose | Specialist | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2019-05-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023675212 | Kennedy Wayne Germany Jr. | Specialist/Technologist | 813 Seashell Cove, Madison, TN 37115 | 2019-05-22 |
| 1497211387 | Latasha Monique Williams | Social Worker | Patriot Place (va), 314 Williams Avenue, Ste. 100, Madison, TN 37115 | 2019-02-15 |
| 1659866481 | Amanda Elliott | Pharmacist | 109 Gallatin Rd, Madison, TN 37115 | 2018-06-25 |
| 1760938492 | Larry Cox | Case Manager/Care Coordinator | 620 S. Gallatin Pike, Madison, TN 37115 | 2016-09-01 |
| 1407202799 | National Vision, Inc. | Technician/Technologist | 1785 Gallatin Pike N, Madison, TN 37115 | 2016-05-05 |
| 1992190193 | Emily Tibbs | Case Manager/Care Coordinator | 620 Gallatin Pike, Madison, TN 37115 | 2015-04-03 |
| 1164829982 | Laura Boswell | Case Manager/Care Coordinator | 620 Gallatin Pike South, Madison, TN 37115 | 2014-11-21 |
| 1720498058 | Edward Andrew Roberts | Chiropractor | 1710 Gallatin Pike N, Madison, TN 37115 | 2014-05-08 |
| 1700296217 | Lamonia Merritt | Student in an Organized Health Care Education/Training Program | 645 Cheyenne Blvd, Madison, TN 37115 | 2014-05-06 |
| 1629497656 | Corey Joseph Cloud | Dentist | 500 Lentz Dr Ste 40, Madison, TN 37115 | 2014-04-07 |
| Find all providers in zip 37115 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609484716 | Taneeka Barfield | Licensed Practical Nurse | 168 Ne Gibson Trailer Park Way Lot 10, Madison, FL 32340-2825 | 2020-07-15 |
| 1033751177 | Bionca Buie | Licensed Practical Nurse | 810 Jupiter Dr Apt 304, Madison, WI 53718-2991 | 2019-10-10 |
| 1689135469 | Geraldine Clemons-walker | Licensed Practical Nurse | 2461 Old Camden Sq Apt 104, Madison, WI 53718-8012 | 2019-03-26 |
| 1417449638 | Ashley Renee Zander | Licensed Practical Nurse | 1715 Camus Ln Apt 7, Madison, WI 53705-1204 | 2018-06-04 |
| 1184151466 | Debra Cooks Boatman | Licensed Practical Nurse | 1062 Ne Reagan Rd, Madison, FL 32340-5541 | 2017-05-17 |
| 1972042018 | Shirley Haynes | Licensed Practical Nurse | 219 Sw Third Ave, Madison, FL 32340-2906 | 2017-02-22 |
| 1700329125 | Sheilakay Ann Jowett | Licensed Practical Nurse | 7530 Mid Town Rd Apt 108, Madison, WI 53719-3460 | 2016-12-02 |
| 1124570841 | Shirley Norman-johnson | Licensed Practical Nurse | 115 East Badger Rd, Suite A, Madison, WI 53713 | 2016-10-28 |
| 1114475225 | Jesse Willard | Licensed Practical Nurse | 1128 Morraine View Dr, Unit 301, Madison, WI 53719-3078 | 2016-09-18 |
| 1366809113 | Maria Joseph | Licensed Practical Nurse | 2925 Wimbledon Way, Madison, WI 53713-3427 | 2016-01-25 |
| Find all providers in MADISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.