Sandra S Kopacz, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

032179 Issued in GA

Practice address

259 Broad St
Hawkinsville, GA 31036-4818

Phone

(478) 783-9340

Fax

(478) 783-3961

NPI assigned

Jul 8, 2005

Last updated

Sep 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sandrakopacz@trh.allscriptsdirect.net

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.

• Taylor Regional Hospital

  • Rural Acute Care Hospital
  • Hawkinsville, GA
  • NPI 1720189517
  Medicare reassignment NPD
• Careconnect Health, Inc.

  dba CareConnect Convenient Care

  • Federally Qualified Health Center (FQHC)
  • Sylvester, GA
  • NPI 1811874696
  NPD (past)
• Plains Medical Center, Inc,

  • Family Medicine Physician
  • Limon, CO
  • NPI 1245234525
  NPD (past)

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1396743803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 BROAD ST",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310364818",
            "telephone_number": "478-300-7107",
            "fax_number": "478-783-3961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 BROAD ST",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310364818",
            "telephone_number": "478-783-9340",
            "fax_number": "478-783-3961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPACZ",
        "first_name": "SANDRA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "032179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kellontreia Laporche Jackson, A-GNP-C
• Megan B Jacobs, PHARMD.
• Rheal Adrien Janelle Jr., RPH
• Brandi S Jernander, NP-C
• Stephanie Watkins Kirkland, RPH
• Sara Lafayette, MD
• Lynne Lamberth, WHCNP-BC
• Ginger Lancaster
• Bailey F Lanier, NP
• Matthew Keith Lauritsen, PHARMD

• Pediatrics Physician in Hawkinsville, GA
• Providers in Hawkinsville, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.