Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Russell David Koesters, PA

Individual provider Surgical Physician Assistant · NPI 1871161323

Russell David Koesters, PA is a Physician Assistant in Johnson City, Tennessee. Qualified in 2021, 5 years ago. Practices with Watauga Orthopaedics PLC, a 82-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
5
Licensed in
TN
In the registry since
2021
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2410 Susannah St
Johnson City, TN 37601-1748
Phone: (423) 282-9011
Fax: (423) 282-0035
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 340 Steeles Rd, Bristol, TN 37620-9532 — (423) 722-0284
  • 875 Larry Neil Way, Kingsport, TN 37660-6368 — (423) 282-9011

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 4616 (TN)

Record details

NPI number1871161323
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 11, 2021
Last updated in NPPESJune 11, 2021
Certification dateJune 11, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Watauga Orthopaedics Plc — 82 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Johnson City