Individual provider Active NPI

Tracy Renee Copley, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Gallipolis, OH
National Provider Identifier
1114451143
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.021213 Issued in OH
Practice address
100 Jackson Pike
Gallipolis, OH 45631-1560
Phone
(855) 446-5937
Fax
(740) 441-3396
NPI assigned
Apr 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4023021 KY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN83514-PMHNP-BC WV
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024190452 VA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.021213 OH Primary

Addresses

Primary practice location

100 Jackson Pike
Gallipolis, OH 45631-1560

Mailing address

90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-5000

Other practice location 1

1530 Lone Oak Rd
Paducah, KY 42003-7901
Phone (513) 853-8520

Other practice location 2

7025 Harbour View Blvd Ste 118
Suffolk, VA 23435-2762
Phone (513) 853-8520

Other identifiers 1

IdentifierTypeStateIssuer
0086664MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tracy.copley.2@17389.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, VA, KY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20170912001339 OH Practitioner - Nurse Practitioner 3577836634 Reassigns benefits to 7 organizations
I20240829004688 VA Practitioner - Nurse Practitioner 3577836634 Reassigns benefits to 2 organizations
I20240920000651 KY Practitioner - Nurse Practitioner 3577836634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holzer Clinic LLCGroup PAC ID 5890606008, 266 clinicians

Practice addresses (Care Compare)

100 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-5050

170 Jackson Pike
Gallipolis, OH 45631-1539
Phone (740) 446-5474

90 Jackson Pike
Gallipolis, OH 45631-1560

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.27 of 100Reported as group
Quality
68.56
Promoting interoperability
100
Improvement activities
40
Cost
68.7

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4023021KYMDPsychiatric/Mental Health Nurse Practitioner
APRN.CNP.021213OHMDPsychiatric/Mental Health Nurse Practitioner
APRN83514-PMHNP-BCWVMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Lima Specialty Care LLC CurrentSince Aug 25, 2024 Accepting new patients
Mercy Health Physicians Lorain Specialty Care LLC CurrentSince Aug 25, 2024 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Oct 1, 2024 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Oct 1, 2024 Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Aug 25, 2024 Accepting new patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Aug 25, 2024 Accepting new patients
Mercy Health Physicians Lorain Specialty Care LLC CurrentSince Aug 25, 2024 Accepting new patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Aug 25, 2024 Accepting new patients
Holzer Clinic, LLC CurrentSince Aug 16, 2017 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Aug 25, 2024 Accepting new patients
Mercy Health Physicians Springfield Specialty Care LLC CurrentSince Aug 25, 2024 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Aug 25, 2024 Accepting new patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Aug 25, 2024 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Aug 25, 2024 Accepting new patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Aug 25, 2024 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Current Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Aug 25, 2024 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Aug 25, 2024 Accepting new patients
I Path LLC Current Accepting new patients
Holzer Hospital Foundation Past Accepting new patients
Mercy Health Physicians Kentucky LLC Past Accepting new patients

Locations

1530 Lone Oak Rd
Paducah, KY 42003
Phone (270) 444-2444

1532 Lone Oak Rd
Ste 320
Paducah, KY 42003
Phone (270) 415-3830

578 N Leavitt Rd
Amherst, OH 44001
Phone (440) 960-3912

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

90 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5131

100 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5050

170 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5129

280 Pattonsville Rd
Jackson, OH 45640
Phone (740) 395-8805

830 W High St
Ste 390
Lima, OH 45801
Phone (419) 995-4960

830 W High St
Lima, OH 45801
Phone (419) 226-9694

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

201 Old Bank Rd
Ste 103
Milford, OH 45150
Phone (513) 248-0100

100 Medical Center Dr
Springfield, OH 45504
Phone (937) 523-1000

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

2200 Jefferson Ave
Toledo, OH 43604
Phone (419) 241-1400

900 Scioto St
Ste 1
Urbana, OH 43078
Phone (937) 653-4666

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

5818 Harbour View Blvd
Ste 240
Suffolk, VA 23435
Phone (757) 397-2383

7025 Harbour View Blvd
Ste 118
Suffolk, VA 23435

Interoperability endpoints

  • Direct secure messaging: tracy.copley.2@17389.direct.athenahealth.com

Organizations & group practices 21

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 21

Hospital & facility affiliations 1

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": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1114451143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-446-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "855-446-5937",
            "fax_number": "740-441-3396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1530 Lone Oak Rd",
            "address_purpose": "LOCATION",
            "city": "Paducah",
            "state": "KY",
            "postal_code": "420037901",
            "country_code": "US",
            "telephone_number": "513-853-8520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7025 Harbour View Blvd Ste 118",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234352762",
            "country_code": "US",
            "telephone_number": "513-853-8520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COPLEY",
        "first_name": "TRACY",
        "middle_name": "RENEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "4023021",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WV",
            "license": "APRN83514-PMHNP-BC",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024190452",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.021213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0086664",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tracy.copley.2@17389.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "100 Jackson Pike",
            "city": "Gallipolis",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456311560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gallipolis, OH

Sources for this page

Verify at the official NPI Registry.