SAMIA JACKSON (APRN) – Primary Care Nurse Practitioner, NPI 1013565811
Primary Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for SAMIA JACKSON (APRN)
6520, Fort Caroline Road, Newcastle, Jacksonville, Duval County, Florida, 32277, United States
JACKSONVILLE, FL 322772044
Phone: (904) 744-7300
Fax: (904) 722-4271
Type: Mailing
4160 Southside Blvd Ste 10
Jacksonville, FL 322168500
Phone: (904) 900-1717
Fax: (904) 367-2143
Type: Location
1633 RACE TRACK RD STE 101
ST JOHNS, FL 322593237
Phone: (904) 230-6988
Fax: (904) 342-4028
Type: Mailing
14444 BEACH BLVD STE 28
JACKSONVILLE, FL 322502080
Phone: (904) 367-2277
Fax: (904) 421-3788
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $15.
Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.
Last reported payment date: 2023-01-13 • Largest payer in this snapshot: ABBVIE INC. ($15).
Total Amount
$15
General + Research + Ownership
Payments
1
Total payment records
General Amount
$15
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-01-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $15 |
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: 2020-01-22
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200122000174 | I | Nurse Practitioner | FL | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 120 | 102 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 55 | 55 | $0 |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 31 | 29 | $0 |
| 81003 | Automated urinalysis test | 27 | 26 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 18 | 13 | $0 |
Insurance plans in this area (ZIP 32277)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Physician Assistant | NY | |
| Nurse Practitioner | VA | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Physician Assistant | NY | |
| Physician Assistant | SC | |
| Physician Assistant | FL | |
| Physician Assistant | FL |
Reviews
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