SAMANTHA C BOUGHER APN
NPI 1205728359
Nurse Practitioner - Acute Care in Chattanooga, TN

Q: What is Samantha Bougher's NPI number?

The NPI number for Samantha Bougher is 1205728359. It was assigned to this individual provider in the NPPES registry on July 15, 2025.

Q: What is Samantha Bougher's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Bougher was last updated on July 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.

Active since July 15, 2025PECOS EnrolledAccepts Medicare Assignment

2525 DESALES AVE STE F1009, CHATTANOOGA, TN 37404(423) 624-5200(423) 697-2320 Get Directions Write a Review

NPPES record last updated: July 15, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Samantha C Bougher Apn NPPES

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

SAMANTHA C BOUGHER APN (NPI 1205728359) is an individual acute care provider in Chattanooga, Tennessee, licensed in Tennessee (39041) and active in the NPI registry since July 2025. She is enrolled in Medicare PECOS, is affiliated with Memorial Healthcare System, Inc, and maintains a secondary practice location in Chattanooga.

NPPES Registry Identity

NPI1205728359

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameSAMANTHA C BOUGHERCredential: APN

Location Address2525 DESALES AVE STE F1009Chattanooga, TN 37404-1161

Mailing Address2501 Citico AveChattanooga, TN 37404-1127 · (423) 697-2000 · Fax (423) 697-2320

Phone(423) 624-5200

Fax(423) 697-2320

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateJuly 15, 2025

NPPES CertifiedJuly 15, 2025

✔ NPI 1205728359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in TN · 39041

2525 DESALES AVE STE F1009, Chattanooga, TN 37404

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Secondary Practice Location 1

Location 12501 Citico AveChattanooga, TN 37404-1127 · Phone (423) 697-2000 · Fax (423) 697-2320

Other Identifiers 1

Other39041TN · Apn License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samantha C Bougher 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 ID4688182157

PECOS Enrollment IDI20250805002790

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.

Medicare Billing Reassignment

Medicare enrollment records show Samantha Bougher reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Memorial Health Care System Inc.

Same address

General Acute Care Hospital

2525 DESALES AVE
Chattanooga, TN 37404

Reassigned Medicare billing, Tennessee enrollment
66 clinicians in this Medicare group

NPI 1255428736 (423) 495-2525

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Healthcare System, Inc

Acute Care Hospitals · Chattanooga, TN

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number440091

Location2525 Desales AveChattanooga, TN 37404 · Hamilton County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37404 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.

Other Providers at the Same Location NPPES 8

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

BRETT ALEX MELNIKOFF MD

Thoracic Surgery (Cardiothoracic Vascular Surgery)