DR. SAMUEL TERRY JOHNSON JR. M.D.
NPI 1427296276
Family Medicine in Bolivar, TN

Q: What is Samuel Johnson's NPI number?

The NPI number for Samuel Johnson is 1427296276. It was assigned to this individual provider in the NPPES registry on February 2, 2009.

Q: What is Samuel Johnson'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 Johnson was last updated on December 14, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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 February 02, 2009PECOS Enrolled

629 NUCKOLLS RD, BOLIVAR, TN 38008(731) 658-3388(731) 658-4079 Get Directions Write a Review

NPPES record last updated: December 14, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Samuel Terry Johnson Jr. M.d. NPPES

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

DR. SAMUEL TERRY JOHNSON JR. M.D. (NPI 1427296276) is an individual family medicine provider in Bolivar, Tennessee, licensed in Tennessee (47830) and active in the NPI registry since February 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1427296276

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. SAMUEL TERRY JOHNSON JR.Credential: M.D.

Location Address629 NUCKOLLS RDBolivar, TN 38008-1599

Mailing AddressPo Box 720Bolivar, TN 38008-0720 · (731) 659-3125 · Fax (731) 659-3131

Phone(731) 658-3388

Fax(731) 658-4079

Sole ProprietorNo

Enumeration DateFebruary 2, 2009

Last NPPES UpdateDecember 14, 2011

✔ NPI 1427296276 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in TN · 47830

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.

629 NUCKOLLS RD, Bolivar, TN 38008

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Other Identifiers 1

Medicare PIN103I087769TN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Samuel Terry Johnson Jr. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38008 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier19 claims19 services$109.84 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 19

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

MS. JEANNIE A FERRI FNP

Nurse Practitioner (Family)