KASSI LAITEN COPELAND (PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1164306692

KASSI LAITEN COPELAND (PMHNP-BC) is a healthcare provider. based in Valdosta, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP-BC. They hold a License No. RN303897 (GA). The NPI Number for KASSI LAITEN COPELAND (PMHNP-BC) is 1164306692

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
KASSI LAITEN COPELAND (PMHNP-BC)
NPI
1164306692
Phone
(229) 671-6170
Address
3120 N OAK STREET EXT STE C
Enumeration Date
5 August 2025
Last Update Date
7 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2294337473
Graduation Year
2025 (1 year ago)
PAC ID
7517467905
Group Practice PAC ID
4082036843
Professional Enrollment ID
I20250820004641
Address ID
GA316022577VA2109XSTXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for KASSI LAITEN COPELAND (PMHNP-BC)

  • 3120 N OAK STREET EXT STE C

    VALDOSTA, GA 316025910

    Phone: (229) 671-6170

    Type: Mailing

  • 3120 N OAK STREET EXT STE B

    VALDOSTA, GA 316025910

    Phone: (229) 671-6170

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250820004641INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31602)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082036843View full group profile
NameSpecialtyState
Nurse PractitionerGA
Family PracticeGA
Critical Care (Intensivists), Internal Medicine, Pulmonary DiseaseNY
Orthopedic SurgeryGA
N E U R O L O G YGA
General Surgery, Vascular SurgeryGA
Pulmonary Disease, Sleep MedicineWI
N E U R O S U R G E R YCA
Family PracticeGA
Thoracic Surgery, General SurgeryGA

Reviews

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Frequently asked questions

What number should I use to identify KASSI LAITEN COPELAND (PMHNP-BC) for billing?
Administrative and clinical systems typically use NPI 1164306692 for KASSI LAITEN COPELAND (PMHNP-BC).
Does the public listing show KASSI LAITEN COPELAND (PMHNP-BC) as active?
KASSI LAITEN COPELAND (PMHNP-BC)'s NPI record reflects an active status in NPPES.
What services align with KASSI LAITEN COPELAND (PMHNP-BC)'s listing?
KASSI LAITEN COPELAND (PMHNP-BC)'s public classification highlights Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to KASSI LAITEN COPELAND (PMHNP-BC)?
The directory associates KASSI LAITEN COPELAND (PMHNP-BC) with Valdosta, Georgia. Check all listed addresses for suites or satellite offices.
Why is information missing for KASSI LAITEN COPELAND (PMHNP-BC)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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