Individual provider Active NPI

Heather Cowan, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Blacksburg, VA
National Provider Identifier
1699346023
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11014092 Issued in FL
Practice address
2703 Heritage LN
Blacksburg, VA 24060-8102
Phone
(540) 951-1768
NPI assigned
Jul 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11014092 FL Primary

Addresses

Primary practice location

2703 Heritage LN
Blacksburg, VA 24060-8102

Mailing address

2935 Center St
Coconut Grove, FL 33133-3780
Phone (540) 951-1768

Other practice location 1

3390 Mary St Ste 116
Coconut Grove, FL 33133-5255
Phone (786) 496-2009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240108003599 FL Practitioner - Nurse Practitioner 0042661787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2935 Ctr St
Coconut Grove, FL 33133-3780
Phone (786) 496-2009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11014092FLMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1699346023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2935 CENTER ST",
            "city": "COCONUT GROVE",
            "state": "FL",
            "postal_code": "331333780",
            "telephone_number": "540-951-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 HERITAGE LN",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240608102",
            "telephone_number": "540-951-1768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3390 Mary St Ste 116",
            "address_purpose": "LOCATION",
            "city": "Coconut Grove",
            "state": "FL",
            "postal_code": "331335255",
            "country_code": "US",
            "telephone_number": "786-496-2009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COWAN",
        "first_name": "HEATHER",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11014092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

Verify at the official NPI Registry.