Individual provider Active NPI

Samantha C Bougher, APN

  • Acute Care Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1205728359
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
39041 Issued in TN
Practice address
2525 Desales Ave Ste F1009
Chattanooga, TN 37404-1161
Phone
(423) 624-5200
Fax
(423) 697-2320
NPI assigned
Jul 15, 2025
Last updated
Jul 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 39041 TN Primary

Addresses

Primary practice location

2525 Desales Ave Ste F1009
Chattanooga, TN 37404-1161

Mailing address

2501 Citico Ave
Chattanooga, TN 37404-1127
Phone (423) 697-2000

Other practice location 1

2501 Citico Ave
Chattanooga, TN 37404-1127
Phone (423) 697-2000

Other identifiers 1

IdentifierTypeStateIssuer
39041OtherTNAPN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250805002790 TN Practitioner - Nurse Practitioner 4688182157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Health Care System Inc.Group PAC ID 8628978210, 56 clinicians

Practice addresses (Care Compare)

2525 Desales Ave
Chattanooga, TN 37404-1161
Phone (423) 495-2525

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39041TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health Care System Inc. Current Accepting new patients
Memorial Health Care System, Inc. CurrentSince Jul 21, 2025 Accepting new patients
Cardiovascular Group, PC Current Accepting new patients

Locations

1949 Gunbarrel Rd
Ste 300
Chattanooga, TN 37421

2501 Citico Ave
Chattanooga, TN 37404
Phone (423) 697-2318

2525 Desales Ave
Ste F1009
Chattanooga, TN 37404
Phone (423) 624-5200

400 Berywood Trl NW
Ste A
Cleveland, TN 37312
Phone (423) 697-3560

2051 Hamill Rd
Ste 204
Hixson, TN 37343
Phone (423) 870-2450

Interoperability endpoints

  • Direct secure messaging: samantha.bougher@direct.chattanoogaheart.nextgenshare.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1752537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1205728359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CITICO AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041127",
            "telephone_number": "423-697-2000",
            "fax_number": "423-697-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 DESALES AVE STE F1009",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041161",
            "telephone_number": "423-624-5200",
            "fax_number": "423-697-2320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 Citico Ave",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374041127",
            "country_code": "US",
            "telephone_number": "423-697-2000",
            "fax_number": "423-697-2320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUGHER",
        "first_name": "SAMANTHA",
        "middle_name": "C",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "39041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN LICENSE",
            "identifier": "39041",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.