Samantha A. Cornett, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10002828A Issued in IN

Practice address

4199 Gateway Blvd
Newburgh, IN 47630-8940

Phone

(812) 842-4200

NPI assigned

Oct 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Deaconess Women'S Hospital of Southern Indiana, LLC

  • Gynecologic Oncology Physician
  • Newburgh, IN
  • NPI 1114297801

  Physician Assistant

  NPD (past)
• The Women'S Hospital

  • Pharmacy
  • Newburgh, IN
  • NPI 1891827523
  NPD (past)

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1366085789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637273",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452637273",
            "telephone_number": "812-842-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4199 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308940",
            "telephone_number": "812-842-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 Riley Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025109",
            "country_code": "US",
            "telephone_number": "317-274-4779",
            "fax_number": "317-948-9806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNETT",
        "first_name": "SAMANTHA",
        "middle_name": "A.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-18",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002828A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "10002828A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300032484",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cook Pediatric Dentistry
• Sean Leland Cook, D.D.S.,M.S.D.
• Vivian C Cook, M.D.
• Sean Cooley, RBT
• Shannon Copeland
• Lisa Cossey, LCSW
• Caroline Coughlin, APRN
• Tabatha Covington
• Tanya Cowans
• Alicea Cox

• All providers in Newburgh, IN
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.