SAMANTHA JACKSON MD PLLC – Family Medicine Physician, NPI 1275973646

SAMANTHA JACKSON MD PLLC is a healthcare provider. based in Hobart, Oklahoma. specializing in Family Medicine Physician. The organization holds a License No. 19876 (OK). The NPI Number for SAMANTHA JACKSON MD PLLC is 1275973646

Main info

Organization
Name
SAMANTHA JACKSON MD PLLC
NPI
1275973646
Phone
(580) 726-2226
Address
415 W FOREST LN
Authorized Official
SAMANTHA L JACKSON OWNER M.D.
Enumeration Date
1 July 2013
Last Update Date
16 January 2017
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

Provider Addresses for SAMANTHA JACKSON MD PLLC

  • 415 W FOREST LN

    HOBART, OK 736511645

    Phone: (580) 726-2226

    Fax: (580) 726-8425

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2013-11-12

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20131112000284OClinic/Group PracticeOKTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 73651)

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Reviews

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Frequently asked questions

What number should I use to identify SAMANTHA JACKSON MD PLLC for billing?
Administrative and clinical systems typically use NPI 1275973646 for SAMANTHA JACKSON MD PLLC.
Quick check: is SAMANTHA JACKSON MD PLLC active?
Public NPPES data shows SAMANTHA JACKSON MD PLLC with an active NPI status right now.
What does the directory say SAMANTHA JACKSON MD PLLC does?
Insurance directories may phrase it differently, but here SAMANTHA JACKSON MD PLLC maps to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to SAMANTHA JACKSON MD PLLC?
SAMANTHA JACKSON MD PLLC is associated with Hobart, Oklahoma in the same public data insurers reference.
Can I export SAMANTHA JACKSON MD PLLC's record?
You can download the official NPPES record; we summarize key fields for readability.

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