Individual provider Active NPI

Lee Roy Copeland, M.D.

  • Internal Medicine Physician
  • Clovis, CA
National Provider Identifier
1619958501
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G32186 Issued in CA
Practice address
255 W Herndon Ave Ste 103
Clovis, CA 93612-0381
Phone
(559) 570-0070
Fax
(559) 570-0059
NPI assigned
Nov 8, 2005
Last updated
Apr 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G32186 CA Primary

Addresses

Primary practice location

255 W Herndon Ave Ste 103
Clovis, CA 93612-0381

Mailing address

255 W Herndon Ave Ste 103
Clovis, CA 93612-0381
Phone (559) 570-0070

Other identifiers 4

IdentifierTypeStateIssuer
77040368493612B008OtherCACHAMPUS
00G321860OtherCABLUE CROSS/BLUE SHIELD
110115369OtherCARAILROAD MEDICARE
00G321860MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20080630000116 CA Practitioner - Internal Medicine 0749188464 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smartcare Medical Group, IncGroup PAC ID 7012318785, 4 clinicians

Practice addresses (Care Compare)

255 W Herndon Ave
Suite 103
Clovis, CA 93612-0381
Phone (559) 570-0070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G32186CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Smartcare Medical Group, Inc. CurrentSince Mar 1, 2021 Accepting new patients
Community Health Partners CurrentSince Mar 1, 2022 Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients

Locations

245 W Herndon Ave
Clovis, CA 93612
Phone (559) 299-1178

255 W Herndon Ave
Ste 103
Clovis, CA 93612
Phone (559) 326-2999

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

2335 E Kashian Ln
Ste 30
Fresno, CA 93701
Phone (559) 284-7264

2335 E Kashian Ln
Ste 301
Fresno, CA 93701
Phone (559) 224-5864

45 E River Park Pl W
Ste 104
Fresno, CA 93720
Phone (559) 320-0550

7145 N Chestnut Ave
Ste 101
Fresno, CA 93720
Phone (559) 284-7264

805 W Acequia Ave
Ste 2D
Visalia, CA 93291
Phone (559) 622-8687

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1619958501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W HERNDON AVE STE 103",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120381",
            "telephone_number": "559-570-0070",
            "fax_number": "559-570-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W HERNDON AVE STE 103",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120381",
            "telephone_number": "559-570-0070",
            "fax_number": "559-570-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPELAND",
        "first_name": "LEE",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G32186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "77040368493612B008",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "00G321860",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110115369",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G321860",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.