DR. SAMUEL NELSON COOKE M.D.
NPI 1114281060
Family Medicine in Fayetteville, AR

Q: What is Samuel Cooke's NPI number?

The NPI number for Samuel Cooke is 1114281060. It was assigned to this individual provider in the NPPES registry on June 26, 2012.

Q: What is Samuel Cooke's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Cooke was last updated on December 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 26, 2012PECOS Enrolled

1673 N COLLEGE AVE, FAYETTEVILLE, AR 72703(479) 521-0200(479) 521-4942 Get Directions Write a Review

NPPES record last updated: December 18, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 18, 2018, Jan 26, 2016 (2 updates tracked since 2016).

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About Dr. Samuel Nelson Cooke M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SAMUEL NELSON COOKE M.D. (NPI 1114281060) is an individual family medicine provider in Fayetteville, Arkansas, licensed in Arkansas (E-8505) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS and maintains a secondary practice location in Fayetteville.

NPPES Registry Identity

NPI1114281060

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. SAMUEL NELSON COOKECredential: M.D.

Location Address1673 N COLLEGE AVEFayetteville, AR 72703-1919

Mailing AddressPo Box 1523Fayetteville, AR 72702-1523 · (479) 571-6038 · Fax (479) 582-0222

Phone(479) 521-0200

Fax(479) 521-4942

Sole ProprietorNo

Enumeration DateJune 26, 2012

Last NPPES UpdateDecember 18, 20182 updates tracked since enumeration

✔ NPI 1114281060 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in AR · E-8505

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1673 N COLLEGE AVE, Fayetteville, AR 72703

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Secondary Practice Location 1

Location 1117 E Sycamore StFayetteville, AR 72703-2540 · Phone (479) 521-0200 · Fax (479) 521-4942

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Samuel Nelson Cooke M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Samuel Cooke reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Medical Associates Of Northwest Arkansas PA

Same address

Family Medicine

1673 N COLLEGE AVE
Fayetteville, AR 72703

Reassigned Medicare billing, Arkansas enrollment
125 clinicians in this Medicare group

NPI 1780635466 (479) 521-0200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72703 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$79.72 typical visit price

range $51.36 – $157.74

Typical copayment $19.93 (range $12.84 – $39.43)

Most-billed visit code 99203

Established Patient

$91.63 typical visit price

range $16.16 – $128.77

Typical copayment $22.90 (range $4.04 – $32.19)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SCOTT RYAN BLAND DO

Family Medicine

1673 N COLLEGE AVE
FAYETTEVILLE, AR 72703

Washington County (479) 521-0200

DR. CODY ROSS SMITH M.D.

Family Medicine

1673 N COLLEGE AVE
FAYETTEVILLE, AR 72703

Washington County (479) 521-0200

DAVID E HANKS PA-C

Physician Assistant

1673 N COLLEGE AVE
FAYETTEVILLE, AR 72703

Washington County (479) 521-0200

MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS PA

Family Medicine

1673 N COLLEGE AVE
FAYETTEVILLE, AR 72703

Washington County (479) 521-0200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Cooke's NPI number?

The NPI number for Samuel Cooke is 1114281060. It was assigned to this individual provider in the NPPES registry on June 26, 2012.

Where is Samuel Cooke located?

Samuel Cooke practices at 1673 N College Ave, Fayetteville, AR 72703. The listed phone number is (479) 521-0200.

What is Samuel Cooke's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Samuel Cooke enrolled in Medicare?

Yes. Samuel Cooke is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Samuel Cooke's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Cooke reassigns Medicare benefits to Medical Associates Of Northwest Arkansas PA (Fayetteville, AR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samuel Cooke's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samuel Cooke accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Samuel Cooke as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samuel Cooke was last updated on December 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.