SAMUEL WILLIAM III COOK (PAC) – Physician Assistant, NPI 1033307939

SAMUEL WILLIAM III COOK (PAC) is a healthcare provider. based in Johnson city, Tennessee. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PAC. They hold a License No. 305 (TN). The NPI Number for SAMUEL WILLIAM III COOK (PAC) is 1033307939

Main info

Male
35 Years Of Experience
Accepts Medicare Assignment
Name
SAMUEL WILLIAM III COOK (PAC)
NPI
1033307939
Phone
(423) 282-9011
Address
2410 SUSANNAH ST
Enumeration Date
5 October 2007
Last Update Date
16 December 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4232971813
Graduation Year
1991 (35 years ago)
PAC ID
6002998036
Group Practice PAC ID
1355416306
Professional Enrollment ID
I20080130000435
Address ID
TN376432504EL420XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:18State licenses:1Digital endpointsOther names

3,118 PHYSICIAN ASSISTANT in TN

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Provider Addresses for SAMUEL WILLIAM III COOK (PAC)

  • 2410, Susannah Street, Princeton Hills, Johnson City, Washington County, Tennessee, 37601, United States

    JOHNSON CITY, TN 376011748

    Phone: (423) 282-9011

    Fax: (423) 282-0035

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-01-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080130000435IPhysician AssistantTNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J7322Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg2,85639$0
J0702Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg26643$0
99214Established patient office or other outpatient visit, 30-39 minutes198136$0
20610Aspiration and/or injection of fluid from large joint15676$0
73562X-ray of knee, 3 views8857$0
View full utilization report →

Insurance plans in this area (ZIP 37601)

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Provider's Procedures

SAMUEL WILLIAM III COOK (PAC) performs procedures in PHYSICIAN ASSISTANT. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTTN20610Aspiration and/or injection of large joint or joint capsule12077
PHYSICIAN ASSISTANTTN73110X-ray of wrist, minimum of 3 views4019

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355416306View full group profile
NameSpecialtyState
Nurse PractitionerTN
Internal MedicineTN
Nurse PractitionerTN
Family PracticeTN
Internal MedicineTN
Sports Medicine, Orthopedic SurgeryTN
Sports Medicine, Orthopedic SurgeryMS
Nurse PractitionerTN
Orthopedic SurgeryTN
Nurse PractitionerTN

Reviews

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Frequently asked questions

Does SAMUEL WILLIAM III COOK (PAC) have a public NPI I can cite?
Public records show SAMUEL WILLIAM III COOK (PAC) under NPI 1033307939.
Quick check: is SAMUEL WILLIAM III COOK (PAC) active?
Public NPPES data shows SAMUEL WILLIAM III COOK (PAC) with an active NPI status right now.
What services align with SAMUEL WILLIAM III COOK (PAC)'s listing?
SAMUEL WILLIAM III COOK (PAC)'s public classification highlights Physician Assistant. Clinical services aligned with this taxonomy classification.
Can patients visit SAMUEL WILLIAM III COOK (PAC) in Johnson City, Tennessee?
For routing, start with Johnson City, Tennessee for SAMUEL WILLIAM III COOK (PAC), then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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