NPIMap

Individual provider Active NPI

Susan Kathleen Copley, MD

  • Emergency Medicine Physician
  • Hartselle, AL
National Provider Identifier
1689627556
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
18715 Issued in AL
Practice address
201 Pine St NW
Hartselle, AL 35640-2309
Phone
(904) 805-1300
Fax
(904) 805-1302
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 18715 AL Primary

Addresses

Primary practice location

201 Pine St NW
Hartselle, AL 35640-2309

Mailing address

4461 County Road 411
Groveoak, AL 35975-4843
Phone (256) 623-6127

Other identifiers 3

IdentifierTypeStateIssuer
51555571OtherALBLUE CROSS
051552917MedicaidAL
009943023MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18715ALMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Correct Care, Inc. Emergency Medicine Past Accepting new patients
Fayette Medical Center Past Accepting new patients
Complete Family Medicine Past Accepting new patients
Inphynet Contracting Services LLC Emergency Medicine Past Accepting new patients
Paragon Contracting Services LLC Emergency Medicine Past Accepting new patients
Willstown Emergency Physicians Emergency Medicine Past Accepting new patients
Pine Emergency Group LLC Emergency Medicine Past Accepting new patients
Northside Onsite Medical Services, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IDFDCD

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.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1689627556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4461 COUNTY ROAD 411",
            "city": "GROVEOAK",
            "state": "AL",
            "postal_code": "359754843",
            "telephone_number": "256-623-6127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PINE ST NW",
            "city": "HARTSELLE",
            "state": "AL",
            "postal_code": "356402309",
            "telephone_number": "904-805-1300",
            "fax_number": "904-805-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPLEY",
        "first_name": "SUSAN",
        "middle_name": "KATHLEEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "18715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51555571",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051552917",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009943023",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartselle, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.