Samuel William Cook Iii, PAC - Medicare Physician Assistant in Johnson City, TN

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Samuel William Cook Iii, PAC is a medicare enrolled "Physician Assistant" in Johnson City, Tennessee. He graduated from nursing school in 1991 and has 35 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Watauga Orthopaedics Plc, Champion Physical Therapy Llc Halls and his current practice location is 2410 Susannah Street, Johnson City, Tennessee. You can reach out to his office (for appointments etc.) via phone at (423) 282-9011.

Samuel William Cook Iii is licensed to practice in Tennessee (license number 305) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1033307939.

Contact Information

Samuel William Cook Iii, PAC
2410 Susannah Street,
Johnson City, TN 37601-1748
(423) 282-9011
(423) 282-0035

Map and Direction




Provider's Profile

Full NameSamuel William Cook Iii
GenderMale
SpecialityPhysician Assistant
Experience35 Years
Location2410 Susannah Street, Johnson City, Tennessee
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Samuel William Cook Iii graduated from nursing school in 1991
  NPI Data:
  • NPI Number: 1033307939
  • Provider Enumeration Date: 10/05/2007
  • Last Update Date: 12/16/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 6002998036
  • Enrollment ID: I20080130000435

Medical Identifiers

Medical identifiers for Samuel William Cook Iii such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033307939NPI-NPPES
1507032MedicaidTN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 305 (Tennessee)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Amedisys Home HealthJohnson city, TNHome health agency
Bristol Regional Medical CenterBristol, TNHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Watauga Orthopaedics Plc145624647985
Champion Physical Therapy Llc Halls1355416306277

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. Samuel William Cook Iii allows following entities to bill medicare on his behalf.
Entity NameWatauga Orthopaedics PLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1245251404
PECOS PAC ID: 1456246479
Enrollment ID: O20040218000903

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. Samuel William Cook Iii 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
Samuel William Cook Iii, PAC
2410 Susannah St,
Johnson City, TN 37601-1748

Ph: (423) 282-9011		Samuel William Cook Iii, PAC
2410 Susannah Street,
Johnson City, TN 37601-1748

Ph: (423) 282-9011

Reviews and Comments


Physician Assistant Nurses in Johnson City, TN

Kevin Ray Hudson, PA
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Practice Location: 410 N State Of Franklin Rd Ste 140, Johnson City, TN 37604
Phone: 423-431-2460    Fax: 423-431-2465
Mikayla L. Bogulski,
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Mckenzie Pearl Gregg, PA-C, MMS, MPH
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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.