DR. SAGE KINNEY COPELAND (NPI# 1265413124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265413124 |
| Entity Type | Individual |
| Full Name | DR. SAGE KINNEY COPELAND |
| Credential | M.D., F.A.C.S. |
| Practice Address |
1218 13th Ave Se Decatur AL 35601-4307 |
| Practice Telephone | 2563556200 |
| Practice Fax Number | 2563556241 |
| Mailing Telephone | 2563556200 |
| Mailing Fax Number | 2563556241 |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2013-01-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 00011018 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | RAILROAD MEDICARE | 040011769 | 01 |
| AL | PROVIDER NUMBER | 051019326 | 01 |
| AL | 000019326 | 05 | |
| AL | BCBS | 510-19326 | 01 |
| Street Address |
1218 13TH AVE SE |
| City | DECATUR |
| State | AL |
| Zip Code | 35601-4307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215445937 | Shawna Marie Cadarette | Physical Therapist | 1218 13th Ave Se, Decatur, AL 35601-4307 | 2018-01-16 |
| 1851833776 | Sung D Kim | Physical Therapist | 1218 13th Ave Se, Decatur, AL 35601 | 2016-11-09 |
| 1871948935 | Frank Fischer | Hearing Instrument Specialist | 1218 13th Ave Se, Decatur, AL 35601-4307 | 2016-04-26 |
| 1982876520 | Randall Wilks | Audiologist | 1218 13th Ave Se, Decatur, AL 35601-4307 | 2008-03-24 |
| 1164487708 | Decatur Ent Assoc., P.C. | Otolaryngology | 1218 13th Ave Se, Decatur, AL 35601-4307 | 2006-04-18 |
| 1558342931 | George H Godwin IIi | Otolaryngology | 1218 13th Ave Se, Decatur, AL 35601-4307 | 2005-11-11 |
| 1295716975 | Kathryn Sulcer | Physical Therapist | 1218 13th Ave Se, Decatur, AL 35601-4307 | 2005-11-09 |
| 1760463632 | Benjamin W Light | Otolaryngology | 1218 13th Ave Se, Decatur, AL 35601-4307 | 2005-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000679 | Monica Dawn Ross | Counselor | 106 Lee St. Ne, Suite C, Decatur, AL 35601 | 2019-02-23 |
| 1063950319 | Samantha Elizabeth Pickett | Nurse Practitioner | 1115 Beltline Rd Se, Ste 400, Decatur, AL 35601 | 2017-02-07 |
| 1497208250 | Beronica Goodwin | Home Health Aide | 1102b Suite #2 4th Ave Se, Decatur, AL 35601 | 2016-07-28 |
| 1770957177 | Xochitl Dupre | Obstetrics & Gynecology | 1874 Beltline Road Sw, Suite 105, Decatur, AL 35601 | 2015-11-23 |
| 1104224708 | River City Psychiatry, Inc. | Community/Behavioral Health | 115 Johnston Street, Se, Suite 202, Decatur, AL 35601 | 2014-12-12 |
| 1760882690 | Derrick Aaron Randolph | Registered Nurse | 1207 7th St S.e., Decatur/morgan Hospital - Parkway Campus, Decatur, GA 35601 | 2014-08-28 |
| 1427465434 | Martha Read | Family Medicine | 2208 Danville Rd Sw Ste A, Decatur, AL 35601 | 2014-07-22 |
| 1205242948 | Pure Heart Home Care of Alabama, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 B 14th Street Sw, Decatur, AL 35601 | 2014-07-02 |
| 1720492242 | Christopher John Phillips | Emergency Medicine | 1201 7th Street Se, Decatur, AL 35601 | 2014-06-12 |
| 1366794711 | Complete Dental Decatur LLC | Dentist | 1241 Point Mallard Parkway, Suite. 105, Decatur, AL 35601 | 2012-10-10 |
| Find all providers in zip 35601 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679720726 | Waymond Jay Pettit | Otolaryngology | 3620 S Taylor Rd, Decatur, IL 62521-9015 | 2008-08-20 |
| 1104883735 | Stephen J Chadwick | Otolaryngology | 101 W Mckinley Ave, Enta Allergy, Head & Neck Institute, Decatur, IL 62522 | 2006-04-27 |
| 1174589634 | Joanne Pham | Otolaryngology | 1600 W Business 380, Suite A, Decatur, TX 76234-3281 | 2006-04-25 |
| 1851356083 | Willis P Callins | Otolaryngology | 4288 Memorial Dr, Ste D, Decatur, GA 30032-1229 | 2006-04-19 |
| 1275531907 | Jenny Christine Kim | Otolaryngology | 484 Irvin Ct, Ste 140, Decatur, GA 30030-5406 | 2005-07-07 |
| 1275857542 | Shivan H Amin | Otolaryngology | 2675 N Decatur Rd, Ste 707, Decatur, GA 30033-6131 | 2010-03-16 |
| 1568646842 | Jeffrey Michael Ulis | Otolaryngology | 101 W Mckinley Ave, Decatur, IL 62526-3286 | 2007-12-22 |
| 1538254727 | Charles R. Potter, M.d., L.L.C. | Otolaryngology | 1770 E Lake Shore Dr, Suite 306, Decatur, IL 62521-3832 | 2006-10-04 |
| 1760597363 | Michelle Marie Cullen | Otolaryngology | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2006-08-21 |
| 1528026580 | Terence R Woods | Otolaryngology | 101 W Mckinley Ave, Enta Allergy, Head & Neck Institute, Decatur, IL 62526 | 2006-05-01 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.