CAMILLE N UPCHURCH MD, NPI 1730186347 — SILVER SPRING (MD)

NPI 1730186347

14+ Years Experience Individual

CAMILLE N UPCHURCH MD

06/29/2005
PROVIDER ENUMERATION DATE
02.07.2019
LAST UPDATE DATE
1730186347
NPI NUMBER

About CAMILLE N UPCHURCH

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

CAMILLE N UPCHURCH is a provider established in SILVER SPRING, MD. The NPI number of CAMILLE N UPCHURCH is 1730186347 and was assigned on 06/29/2005. The practitioners primary taxonomy code is: 207R00000X with license number: MD419533 PA .

Mailing address

  • City: SILVER SPRING
  • State: MD
  • Postal code: 209101460
  • Phone: 3017547991
  • Fax: 3017547990
  • Address: 1500 FOREST GLEN RD

Primary Practice Address

  • Region : SILVER SPRING, MD
  • NPI : 1730186347
  • Phone : 3017547991
  • Fax : 3017547990
  • Postalcode : 20910
  • Address : 1500 FOREST GLEN RD

Additional identifiers

  • Identifier: 1917674
  • Code / Type : 5 - MEDICAID
  • Identifier state : PA

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Provider taxonomy - Internal Medicine

  • Taxonomy code: 207R00000X
  • License number: MD419533
  • License state: PA

The taxonomy is not the primary taxonomy.

Taxonomy description: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Healthcare provider taxonomy #2 - Hospitalist

  • Taxonomy code: 208M00000X
  • License number: C1-0009714
  • License state: DE

The taxonomy is not the primary taxonomy.

Taxonomy description: Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term "hospitalist" refers to physicians whose practice emphasizes providing care for hospitalized patients.

Contacts:

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  • CAMILLE N UPCHURCH MD
  • Address : 1500 FOREST GLEN RD
  • Region : SILVER SPRING, MD
  • NPI : 1730186347
  • Phone : 3017547991
  • Fax : 3017547990
  • Postalcode : 20910

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address1500 FOREST GLEN RD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameSILVER SPRING
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameMD
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code20910
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number3017547991
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number3017547990
The fax number associated with the location address of the provider being identified.
NPI1730186347
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1207R00000X
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Provider Enumeration Date06/29/2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated02.07.2019
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)CAMILLE N UPCHURCH
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address1500 FOREST GLEN RD
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameSILVER SPRING
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameMD
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code209101460
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number3017547991
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number3017547990
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1207R00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Provider License Number 1MD419533
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1PA
Healthcare Provider Primary Taxonomy Switch 1N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 2208M00000X
Healthcare Provider Taxonomy 2Hospitalist
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term "hospitalist" refers to physicians whose practice emphasizes providing care for hospitalized patients.
Provider License Number 2C1-0009714
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2DE
Healthcare Provider Primary Taxonomy Switch 2N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 11917674
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1PA
Other Provider Identifier State #1
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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