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MRS. HEATHER E CUMMINS APN
NPI 1164808713
Nurse Practitioner - Family in Lenoir City, TN

Active since August 05, 2015PECOS EnrolledAccepts Medicare Assignment
501 ADESA BLVD, LENOIR CITY, TN 37771(865) 286-9977(865) 286-9967 Get Directions Write a Review

NPPES record last updated: May 18, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 18, 2023, Jul 13, 2016 (2 updates tracked since 2016).

About Mrs. Heather E Cummins Apn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. HEATHER E CUMMINS APN (NPI 1164808713) is an individual family provider in Lenoir City, Tennessee, licensed in Tennessee (APN0000020092) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS and is a graduate of Lincoln Memorial University Medical Department (2015).

NPPES Registry Identity

NPI1164808713
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. HEATHER E CUMMINSCredential: APN
Location Address501 ADESA BLVDLenoir City, TN 37771-6725
Mailing Address131 Saundersville Rd, Ste 160Hendersonville, TN 37075-8903 · (423) 458-6267 · Fax (423) 790-7136
Phone(865) 286-9977
Fax(865) 286-9967
Sole ProprietorNo
Medical School CMSLincoln Memorial University Medical DepartmentGraduated 2015
Enumeration DateAugust 5, 2015
Last NPPES UpdateMay 18, 20232 updates tracked since enumeration
NPPES CertifiedMay 18, 2023
✔ NPI 1164808713 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TN · APN0000020092
501 ADESA BLVD, Lenoir City, TN 37771
Open in Google Maps ↗

Other Identifiers 1

MedicaidQ015610TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Heather E Cummins Apn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4688984693
PECOS Enrollment IDI20151103002695
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
277 services251 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
112 services96 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
111 services111 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
42 services42 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37771 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation
Percentage of patients aged 18 years and older with a diagnosis of COPD who had spirometry results documented
95%21 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. CONNIE F RUST RPH, DPH
Pharmacist
501 ADESA BLVD
LENOIR CITY, TN 37771
Loudon County (865) 986-4530
JANICE TEAGUE JENKINS FNP
Nurse Practitioner (Family)
501 ADESA BLVD, SUITE A150
LENOIR CITY, TN 37771
Loudon County (865) 986-8082
THYRA LYNN FOLKARD
Case Manager/Care Coordinator
501 ADESA BLVD
LENOIR CITY, TN 37771
Loudon County (865) 986-8082
KERI REBECCA BELL
Licensed Practical Nurse
501 ADESA BLVD
LENOIR CITY, TN 37771
Loudon County (865) 986-8082
AMIR ALI A HUSSAINI MD
Psychiatry & Neurology (Psychiatry)
501 ADESA BLVD, SUITE A-150
LENOIR CITY, TN 37771
Loudon County (865) 986-8082
RAVEN NICOLE BROYLES BS
Case Manager/Care Coordinator
501 ADESA BLVD, STE A-150
LENOIR CITY, TN 37771
Loudon County (865) 986-8082
TAYLOR DUNCAN
Nurse's Aide
501 ADESA BLVD
LENOIR CITY, TN 37771
Loudon County (865) 986-8082
REBECCA MATLOCK LCSW
Social Worker (Clinical)
501 ADESA BLVD, SUITE A-150
LENOIR CITY, TN 37771
Loudon County (865) 986-8082

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Heather Cummins's NPI number?

The NPI number for Heather Cummins is 1164808713. It was assigned to this individual provider in the NPPES registry on August 5, 2015.

Where is Heather Cummins located?

Heather Cummins practices at 501 Adesa Blvd, Lenoir City, TN 37771. The listed phone number is (865) 286-9977.

What is Heather Cummins's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Heather Cummins enrolled in Medicare?

Yes. Heather Cummins is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Heather Cummins accept?

Health plans from BlueCross BlueShield of Tennessee and UnitedHealthcare list Heather Cummins as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Heather Cummins was last updated on May 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.