Krystal Dawn Upshaw, DPM is a medicare enrolled "Podiatrist" provider in Corning, Arkansas. Her current practice location is
1300 Creason Rd, Corning, Arkansas. You can reach out to her office (for appointments etc.) via phone at
(870) 857-3399.
Krystal Dawn Upshaw is licensed to practice in Arkansas (license number 272) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1285046896.
Healthcare Provider's Profile
| Full Name | Krystal Dawn Upshaw |
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| Gender | Female |
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| Speciality | Podiatrist |
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| Location | 1300 Creason Rd, Corning, Arkansas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1285046896
- Provider Enumeration Date: 06/02/2014
- Last Update Date: 05/02/2019
Medicare PECOS Information:
- PECOS PAC ID: 8325342173
- Enrollment ID: I20171017000718
Medical Identifiers
Medical identifiers for Krystal Dawn Upshaw such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1285046896 | NPI | - | NPPES |
| 224176717 | Medicaid | AR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 213E00000X | Podiatrist | 272 (Arkansas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Krystal Dawn Upshaw allows following entities to bill medicare on her behalf.
| Provider Name | Lawrence Memorial Health Foundation Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1528052107
PECOS PAC ID: 9436305836
Enrollment ID: O20191029002135 |
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| Provider Name | Lawrence Memorial Health Foundation Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1962626770
PECOS PAC ID: 9436305836
Enrollment ID: O20191030002298 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Krystal Dawn Upshaw is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Krystal Dawn Upshaw, DPM
Po Box 83,
Corning, AR 72422-0083
Ph: (870) 857-3334 | Krystal Dawn Upshaw, DPM
1300 Creason Rd,
Corning, AR 72422
Ph: (870) 857-3399 |
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