Individual provider Active NPI

Heather Marie Samaniego Cogswell, FNP-BC

  • Family Medicine Physician
  • Clarksville, TN
National Provider Identifier
1750964029
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
SP021735 Issued in PA
Practice address
1690 Fort Campbell Blvd
Clarksville, TN 37042-7531
Phone
(931) 648-4838
NPI assigned
May 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X SP021735 PA Primary

Addresses

Primary practice location

1690 Fort Campbell Blvd
Clarksville, TN 37042-7531

Mailing address

1690 Fort Campbell Blvd
Clarksville, TN 37042-7531
Phone (609) 634-7748

Other names 1

  • Heather Marie Acuna Samaniego Former name

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
I20230825000417 TN Practitioner - Nurse Practitioner 0840653770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crossroads Urgent Care PLLCGroup PAC ID 8325117484, 181 clinicians

Practice addresses (Care Compare)

1690 Fort Campbell Blvd
Clarksville, TN 37042-7531
Phone (931) 648-4838

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP021735PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Urgent Care PLLC Family Medicine CurrentSince Jul 7, 2023 Accepting new patients
Crossroads Urgent Care PLLC Family Medicine CurrentSince Jul 7, 2023 Accepting new patients

Locations

1690 Fort Campbell Blvd
Clarksville, TN 37042
Phone (931) 648-4838

2224 Madison St
Ste B
Clarksville, TN 37043
Phone (931) 503-7015

2445 Memorial Blvd
Ste C
Murfreesboro, TN 37129
Phone (615) 217-6900

30 Burton Hills Blvd
Ste 175
Nashville, TN 37215
Phone (615) 988-2014

Organizations & group practices 2

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": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1750964029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 FORT CAMPBELL BLVD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370427531",
            "telephone_number": "609-634-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 FORT CAMPBELL BLVD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370427531",
            "telephone_number": "931-648-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGSWELL",
        "first_name": "HEATHER MARIE",
        "middle_name": "SAMANIEGO",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "SP021735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER MARIE",
            "last_name": "SAMANIEGO",
            "middle_name": "ACUNA",
            "credential": "BSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.