Jessie Lee Copeland Jr., M.D.
Individual provider Active NPI Adolescent Medicine (Internal Medicine) Physician · Celina, TN
NPI 1164412474 · NPPES record last updated Sep 19, 2019
Key facts
- NPI
- 1164412474
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adolescent Medicine (Internal Medicine) Physician 207RA0000X
- License
- MD30843 (TN)
- Practice address
- 110 Doctors Dr
Celina, TN 38551 - Phone
- (931) 243-3860
- Fax
- (931) 243-4607
- NPI assigned
- Oct 27, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 7
Hospital & facility affiliations 6
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- University of Tennessee, HSC, College of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Amg-Livingston LLC
Practice addresses (Care Compare)
110 Doctors Dr
Celina, TN 38551-5092
Phone (931) 243-3860
Hospital & facility affiliations
- Amedisys Home Health
- Gentiva
- Livingston Regional Hospital
- Cookeville Regional Medical Center
- Monroe County Medical Center
- Celina Health and Rehabilitation Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Celina Health and Rehabilitation Center |
Skilled nursing facility | Corporate Director (100%) Operational/Managerial Control Adp of the SNF |
Dec 20, 2022 Dec 20, 2022 Dec 20, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041005000406 | TN | Practitioner - Internal Medicine | 7911995428 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD30843 | TN | MD | Adolescent Medicine (Internal Medicine) Physician |
| 30843 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amg-Livingston LLC | Current |
Accepting new patients | |
| Amg - Livingston, LLC | Hospitalist | Current |
Accepting new patients |
| Hospital Medicine Services of Tennessee PC | Internal Medicine | Current |
Accepting new patients |
| Cumberland River Hospital Inc | Emergency Medicine | Past |
Accepting new patients |
| Cumberland River Hospital Inc | Past | Accepting new patients | |
| Integrity Healthcare of Celina, LLC | Past | Accepting new patients | |
| Dale Hollow Family Practice LLC | Past | Accepting new patients |
Locations
110 Doctors Dr
Celina, TN 38551
Phone (931) 243-3860
315 Oak St
Livingston, TN 38570
Phone (931) 403-1197
500 W Main St
Livingston, TN 38570
Phone (931) 823-4016
742 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 429-6100
Interoperability endpoints
- jessie.copeland.1@25766.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adolescent Medicine (Internal Medicine) Physician | 207RA0000X | MD30843 | TN | Yes |
| Emergency Medicine Physician | 207P00000X | 30843 | TN | |
| Internal Medicine Physician | 207R00000X | MD30843 | TN | |
| Hospitalist Physician | 208M00000X | 30843 | TN |
Addresses
Primary practice location
110 Doctors Dr
Celina, TN 38551
Mailing address
PO Box 388
Celina, TN 38551-0388
Phone (931) 243-3860
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3726598 | Medicaid | TN | |
| 1510372 | Medicaid | TN | |
| 3837472 | Medicaid | TN | |
| P00162052 | Other | TN | RAILROAD MEDICARE |
| 141913142 | Other | TN | TAX ID |
Other providers in Celina, TN
- Clay County Manor
- Clay County Outpatient Clinic
- April Beth Collins
- Copeland Medical Services
- Ashley Mae Copeland
- County of Clay Office of County
- Cumberland River Hospital Inc
- Cumberland River Hospital Inc
- Cumberland River Hospital Inc
- Cumberland River Hospital Inc
All providers in Celina, TN · Adolescent Medicine (Internal Medicine) Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.