Upstate Carolina Medical LLC
NPI 1457002123ActiveOrganization· Nurse Practitioner· Clemson, SC
Nurse Practitioner in Clemson, South Carolina, registered in NPPES in January 2022. The authorized official on file is Jessica Vassallo, Owner/ Nurse Practitioner.
Overview
| NPI | 1457002123 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 14, 2022 |
| Last updated in NPPES | Jun 1, 2022 |
| Certified by provider | Jun 1, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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