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

Samuel William Cook III, PAC

Individual provider Physician Assistant · NPI 1033307939

Samuel William Cook III, PAC is a Physician Assistant in Johnson City, Tennessee. Qualified in 1991, 35 years ago. Practices with Watauga Orthopaedics PLC, a 82-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
35
Licensed in
TN
In the registry since
2007
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 305 (TN)

Record details

NPI number1033307939
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedOctober 5, 2007
Last updated in NPPESDecember 16, 2019
Certification dateDecember 16, 2019
Mailing address2410 Susannah St, Johnson City, TN 37601-1748

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1991 (35 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