NPIMap

Individual provider Active NPI

Jessie Lee Copeland Jr., M.D.

  • Adolescent Medicine (Internal Medicine) Physician
  • Celina, TN
National Provider Identifier
1164412474
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
MD30843 Issued in TN
Practice address
110 Doctors Dr
Celina, TN 38551
Phone
(931) 243-3860
Fax
(931) 243-4607
NPI assigned
Oct 27, 2005
Last updated
Sep 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X MD30843 TN Primary
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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041005000406 TN Practitioner - Internal Medicine 7911995428 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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 LLCGroup PAC ID 1052225760, 18 clinicians

Practice addresses (Care Compare)

110 Doctors Dr
Celina, TN 38551-5092
Phone (931) 243-3860

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD30843TNMDAdolescent Medicine (Internal Medicine) Physician
TP403KYMDEndocrinology, Diabetes & Metabolism Physician
30843TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amg - Livingston, LLC Hospitalist CurrentSince Nov 13, 2019 Accepting new patients
Hospital Medicine Services of Tennessee PC Internal Medicine CurrentSince Sep 5, 2023 Accepting new patients
Amg-Livingston LLC CurrentSince Nov 13, 2019 Accepting new patients
Integrity Healthcare of Celina, LLC Past Accepting new patients
Cumberland River Hospital Inc Past Accepting new patients
Cumberland River Hospital Inc Emergency Medicine PastSince Nov 1, 2006 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

  • Direct secure messaging: jessie.copeland.1@25766.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Celina Health and Rehabilitation CenterCelina, TN, CCN 445445 Skilled nursing facility Corporate Director (100%)
Operational/Managerial Control
Adp of the SNF		 Dec 20, 2022
Dec 20, 2022
Dec 20, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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 6

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1164412474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "CELINA",
            "state": "TN",
            "postal_code": "385510388",
            "telephone_number": "931-243-3860",
            "fax_number": "931-243-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 DOCTORS DR",
            "city": "CELINA",
            "state": "TN",
            "postal_code": "38551",
            "telephone_number": "931-243-3860",
            "fax_number": "931-243-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPELAND",
        "first_name": "JESSIE",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "TN",
            "license": "MD30843",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "30843",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD30843",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "30843",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Celina, TN

Sources for this page

Verify at the official NPI Registry.