Individual provider Active NPI

Albert D Copeland Jr., M.D.

  • Pediatrics Physician
  • Tifton, GA
National Provider Identifier
1912906199
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
031400 Issued in GA
Practice address
1909 US Highway 82 W Ste 3&4
Tifton, GA 31793-8200
Phone
(229) 445-3509
Fax
(229) 445-3513
NPI assigned
Jul 19, 2005
Last updated
Aug 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 031400 GA Primary

Addresses

Primary practice location

1909 US Highway 82 W Ste 3&4
Tifton, GA 31793-8200

Mailing address

1909 US Highway 82 W Ste 3&4
Tifton, GA 31793-8200
Phone (229) 445-3509

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040216000452 GA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 8224923776 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Jul 1, 2012 Accepting new patients
Phoebe Women's Services CurrentSince Aug 1, 2012 Accepting new patients
Au Medical Associates Inc CurrentSince Jul 1, 2012 Accepting new patients
Phoebe Putney Memorial Hospital Inc CurrentSince Aug 1, 2012 Accepting new patients
Phoebe Putney Memorial Hospital Inc Current Accepting new patients
Sumter Regional Medical Group, PC Past Accepting new patients
Dodge Emergency Group LLC Past Accepting new patients
Americus & Sumter County Hospital Authority Past Accepting new patients
Urgent Care for Children, PLLC Pediatrics PastSince Oct 11, 2020 Accepting new patients
Hospital Authority of Liberty County Past Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients
Inphynet Primary Care Physicians Southeast PC Past Accepting new patients
Fayette Medical Center Past Accepting new patients

Locations

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

100 Wheatley Dr
Americus, GA 31709
Phone (229) 924-6011

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

902 N 7th St
Cordele, GA 31015
Phone (229) 276-3100

910 N 5th St
Ste B
Cordele, GA 31015
Phone (229) 928-1909

101 Lake Oconee Pkwy
Eatonton, GA 31024
Phone (706) 485-0907

Interoperability endpoints

  • Direct secure messaging: albert.copeland@emc.gadirect.net

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1912906199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 US HIGHWAY 82 W STE 3&4",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317938200",
            "telephone_number": "229-445-3509",
            "fax_number": "229-445-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 US HIGHWAY 82 W STE 3&4",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317938200",
            "telephone_number": "229-445-3509",
            "fax_number": "229-445-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPELAND",
        "first_name": "ALBERT",
        "middle_name": "D",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "031400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

Verify at the official NPI Registry.