Individual provider Active NPI

Kristen Copeland, NP

  • Adult Health Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1114443967
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN230567 Issued in GA
Practice address
631 Professional Dr Ste 450
Lawrenceville, GA 30046-3370
Phone
(770) 963-8030
Fax
(770) 339-9577
NPI assigned
Aug 14, 2017
Last updated
Nov 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN230567 GA Primary
Primary Care Nurse Practitioner 363LP2300X RN230567 GA

Addresses

Primary practice location

631 Professional Dr Ste 450
Lawrenceville, GA 30046-3370

Mailing address

1700 Tree LN Ste 490
Snellville, GA 30078-6756
Phone (770) 979-2828

Other identifiers 1

IdentifierTypeStateIssuer
RN230567OtherGALICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kpace@suburban-hemonc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180416000086 GA Practitioner - Nurse Practitioner 8921361486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Oncology Services LLCGroup PAC ID 1850627423, 29 clinicians

Practice addresses (Care Compare)

2098 Teron Trce
Suite 400
Dacula, GA 30019-1664
Phone (678) 722-3940

2800 Buford Dr
Suite 300
Buford, GA 30519-5107
Phone (770) 417-4336

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gwinnett Pathology Assoc PC Current Accepting new patients
Gwinnett Medical Group, Inc Current Accepting new patients
North Atlanta Oncology Services LLC CurrentSince Jul 1, 2019 Accepting new patients

Locations

2098 Teron Trce
Ste 400
Dacula, GA 30019
Phone (678) 312-6800

3620 Howell Ferry Rd
Duluth, GA 30096
Phone (678) 312-3294

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

631 Professional Dr
Ste 450
Lawrenceville, GA 30046
Phone (770) 963-8030

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1700 Tree Ln
Ste 490
Snellville, GA 30078
Phone (770) 963-4445

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1114443967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 TREE LN STE 490",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786756",
            "telephone_number": "770-979-2828",
            "fax_number": "770-979-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR STE 450",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463370",
            "telephone_number": "770-963-8030",
            "fax_number": "770-339-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPELAND",
        "first_name": "KRISTEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-14",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN230567",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN230567",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN230567",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpace@suburban-hemonc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "631 Professional Dr Ste 450",
            "city": "Lawrenceville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300463370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.