Heather Fowler Cumbo, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME121892 Issued in FL

Practice address

415 6TH St
Lewiston, ID 83501-2434

Phone

(208) 750-7445

NPI assigned

Aug 10, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, ID, OH3 enrollments

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 3

Specialty

Psychiatry

Education

Wake Forest University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

HarborGroup PAC ID 8325931181, 58 clinicians

Harmony United Florida, LLCGroup PAC ID 9638306673, 86 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: heather.cumbo@harmonyhealthcare.medentdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Harbor

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Toledo, OH
  • NPI 1366526782

  OH, Psychiatry

  Medicare reassignment Care Compare group NPD
• Harmony United Florida, LLC

  • Psychiatry Physician
  • Winter Garden, FL
  • NPI 1063842870

  FL, Psychiatry

  Medicare reassignment Care Compare group NPD
• St Joseph Hospital LLC

  • Internal Medicine Physician
  • Lewiston, ID
  • NPI 1205368404

  ID, Internal Medicine

  Medicare reassignment NPD
• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000

  FL

  Medicare reassignment NPD
• Ketamine Wellness Centers Jacksonville

  • Pain Medicine (Anesthesiology) Physician
  • Jacksonville, FL
  • NPI 1063016988
  NPD
• MCR Health, Inc.

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD
• East Falls Family Medicine, LLC

  • Family Medicine Physician
  • Idaho Falls, ID
  • NPI 1619221405
  NPD (past)
• Harmony United Pennsylvania PLLC

  • Psychiatry Physician
  • Pottstown, PA
  • NPI 1790637874

  Psychiatry

  NPD (past)

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

{
    "created_epoch": "1218326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1063668077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 E 25TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047542",
            "telephone_number": "208-227-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 6TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012434",
            "telephone_number": "208-750-7445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2280 E 25th St",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834047542",
            "country_code": "US",
            "telephone_number": "208-227-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUMBO",
        "first_name": "HEATHER",
        "middle_name": "FOWLER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-10",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "149697",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "M-13872",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME121892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer C Creaser, ARNP
• Tamara Cronk-Wilson, LCSW
• Muna Crook
• Victoria K Cruz, NP-C
• Kaden Culp, DPT
• Imelda Daley, M.S.
• Kyle James Daly, CRNA
• Ryan Joseph Daly, DNP
• Shain Jessup Dammon, PHARM D
• Dan R Wilson DDS PC

• All providers in Lewiston, ID
• Psychiatry Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.