Dr Samuel Terry Johnson Jr, MD - Medicare Family Medicine in Bolivar, TN

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Dr Samuel Terry Johnson Jr, MD is a medicare enrolled "Family Medicine" physician in Bolivar, Tennessee. His current practice location is 629 Nuckolls Rd, Bolivar, Tennessee. You can reach out to his office (for appointments etc.) via phone at (731) 658-3388.

Dr Samuel Terry Johnson Jr is licensed to practice in Tennessee (license number 47830) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1427296276.

Contact Information

Dr Samuel Terry Johnson Jr, MD
629 Nuckolls Rd,
Bolivar, TN 38008-1599
(731) 658-3388
(731) 658-4079

Map and Direction




Physician's Profile

Full NameDr Samuel Terry Johnson Jr
GenderMale
SpecialityFamily Medicine
Location629 Nuckolls Rd, Bolivar, Tennessee
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1427296276
  • Provider Enumeration Date: 02/02/2009
  • Last Update Date: 12/14/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 8527232941
  • Enrollment ID: I20111122000239

Medical Identifiers

Medical identifiers for Dr Samuel Terry Johnson Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1427296276NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 47830 (Tennessee)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Samuel Terry Johnson Jr allows following entities to bill medicare on his behalf.
Entity NameBolivar General Hospital, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1538634050
PECOS PAC ID: 0648188987
Enrollment ID: O20031229000439
Entity NameHardeman County Community Health Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1861468340
PECOS PAC ID: 5799694147
Enrollment ID: O20040615001290

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Samuel Terry Johnson Jr is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Samuel Terry Johnson Jr, MD
Po Box 720,
Bolivar, TN 38008-0720

Ph: (731) 659-3125		Dr Samuel Terry Johnson Jr, MD
629 Nuckolls Rd,
Bolivar, TN 38008-1599

Ph: (731) 658-3388

Reviews and Comments


Family Medicine Doctors in Bolivar, TN

Judith Anne Tessema,
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 629 Nuckolls Rd, Bolivar, TN 38008
Phone: 731-658-3388    
Dr. Robert Wayne Dunavant, M.D.
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 610 Nuckolls Rd, Bolivar, TN 38008
Phone: 731-658-7111    Fax: 731-658-4328
Dr. John Lee Blankenship, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 629 Nuckolls Rd, Bolivar, TN 38008
Phone: 731-658-3388    Fax: 731-658-4079
Lawrence Diaz, D.O.
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 629 Nuckolls Rd, Bolivar, TN 38008
Phone: 731-658-3388    Fax: 731-658-4079
Olufemi E Soyinka, MD
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 629 Nuckolls Rd, Bolivar, TN 38008
Phone: 731-658-3388    Fax: 731-658-4079
Dr. Nithyananda Pakkala, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 630 Nuckolls Rd, Bolivar, TN 38008
Phone: 731-658-6011    Fax: 731-658-9884

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.