SAMANTHA JACKSON MD
NPI 1104806967
Family Medicine in Hobart, OK

Q: What is Samantha Jackson's NPI number?

The NPI number for Samantha Jackson is 1104806967. It was assigned to this individual provider in the NPPES registry on January 18, 2006.

Q: What is Samantha Jackson'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 Samantha Jackson was last updated on September 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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 January 18, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 37D1011307 · Waiver

90.04/100

CMS Quality Rating

415 W FOREST LN, HOBART, OK 73651(580) 726-2226(580) 726-8425 Get Directions Write a Review

NPPES record last updated: September 25, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Samantha Jackson Md NPPES

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

SAMANTHA JACKSON MD (NPI 1104806967) is an individual family medicine provider in Hobart, Oklahoma, licensed in Oklahoma (19876) and active in the NPI registry since January 2006. She is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through April 6, 2027, and is affiliated with Great Plains Regional Medical Center.

NPPES Registry Identity

NPI1104806967

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameSAMANTHA JACKSONCredential: MD

Location Address415 W FOREST LNHobart, OK 73651-1645

Mailing AddressPo Box 826Hobart, OK 73651-0826 · (580) 726-2226 · Fax (580) 726-8425

Phone(580) 726-2226

Fax(580) 726-8425

Sole ProprietorYes

Medical School CMSUniversity Of Oklahoma College Of MedicineGraduated 1995

Enumeration DateJanuary 18, 2006

Last NPPES UpdateSeptember 25, 2025

NPPES CertifiedSeptember 25, 2025

✔ NPI 1104806967 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in OK · 19876

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.

415 W FOREST LN, Hobart, OK 73651

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Other Identifiers 1

Medicaid100131750DOK

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samantha Jackson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7012002744

PECOS Enrollment IDI20070926000847

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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D1011307

Samantha Jackson, MD PLLC · Hobart, OK

Active · expires Apr 6, 2027

CLIA Number37D1011307

Laboratory TypePhysician Office

Certificate Effective DateApril 7, 2025

Certificate Expiration DateApril 6, 2027

Laboratory DirectorSamantha L. Jackson

Laboratory Phone(580) 726-2226

Laboratory LocationSamantha Jackson, MD PLLC415 W Forest Lane, Hobart, OK 73651

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 19

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

887 services111 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

865 services300 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

538 services277 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

277 services79 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

244 services151 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

196 services58 patients

Injection, ketorolac tromethamine, per 15 mg J1885

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

164 services25 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg J3420

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

133 services21 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

101 services72 patients

Telephone medical discussion with physician, 5-10 minutes 99441

A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.

96 services79 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

85 services56 patients

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

82 services32 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

48 services48 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

42 services36 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

38 services38 patients

Injection, ceftriaxone sodium, per 250 mg J0696

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

29 services21 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

14 services13 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

12 services12 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

12 services12 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Great Plains Regional Medical Center

Acute Care Hospitals · Elk City, OK

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number370019

Location1801 West 3rd StreetElk City, OK 73644 · Beckham County

Emergency services Birthing friendly

Jackson County Memorial Hospital Authority

Acute Care Hospitals · Altus, OK

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number370022

Location1200 East Pecan StAltus, OK 73521 · Jackson County

Emergency services Birthing friendly

Weatherford Regional Hospital, Inc Of Weatherford

Critical Access Hospitals · Weatherford, OK

OwnershipGovernment - Hospital District or Authority

CMS Certification Number371323

Location3701 E MainWeatherford, OK 73096 · Custer County

Emergency services

Cordell Memorial Hospital

Critical Access Hospitals · Cordell, OK

OwnershipGovernment - Hospital District or Authority

CMS Certification Number371325

Location1220 North Glenn English StreetCordell, OK 73632 · Washita County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73651 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

$82.46 typical visit price

range $53.00 – $162.61

Typical copayment $20.61 (range $13.25 – $40.65)

Most-billed visit code 99203

Established Patient

$94.27 typical visit price

range $16.68 – $132.40

Typical copayment $23.56 (range $4.17 – $33.10)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

90.04/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

96.19

Improvement Activities

Cost

56.01

Reported Quality Measures

Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy - Avoidance of Inappropriate Use

100%23 patients

Atrial Fibrillation and Atrial Flutter: Chronic Anticoagulation Therapy

100%25 patients5/55-star benchmark: 100%

Breast Cancer Screening

72%106 patients3/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

0%131 patients5/55-star benchmark: 98%

Non-Recommended Cervical Cancer Screening in Adolescent Females

Lower rates are better for this measure.

0%26 patients

Screening for Osteoporosis for Women Aged 65-85 Years of Age

79%90 patients4/55-star benchmark: 98%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 25

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

4 suppliers56 claims126 services$6.17 avg. paid by Medicare

Normal, low and high calibrator solution / chips A4256

DME-Other DME · category DE000N

1 supplier12 claims12 services$2.95 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

3 suppliers21 claims33 services$1.18 avg. paid by Medicare

Urinary catheter anchoring device, adhesive skin attachment, each A4333

DME-Orthotic Devices · category DF000N

2 suppliers12 claims144 services$2.09 avg. paid by Medicare

Urinary catheter anchoring device, leg strap, each A4334

DME-Orthotic Devices · category DF000N

2 suppliers12 claims12 services$3.95 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

2 suppliers15 claims16 services$6.98 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

6 suppliers18 claims18 services$92.55 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

5 suppliers18 claims45 services$39.57 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

6 suppliers17 claims17 services$22.21 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

5 suppliers22 claims119 services$3.05 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

4 suppliers21 claims21 services$55.11 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

4 suppliers105 claims109 services$20.48 avg. paid by Medicare

Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443

DME-Oxygen and Supplies · category DC000N

2 suppliers11 claims11 services$48.14 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

3 suppliers20 claims20 services$18.67 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

2 suppliers43 claims43 services$5.84 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

2 suppliers16 claims16 services$54.34 avg. paid by Medicare

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

7 suppliers208 claims212 services$112.92 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

2 suppliers18 claims18 services$38.11 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

7 suppliers29 claims7,967 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

6 suppliers53 claims6,240 services$0.09 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

3 suppliers32 claims1,920 services$0.72 avg. paid by Medicare

Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram J7644

DME-Drugs Administered Through DME · category DG006N

2 suppliers16 claims1,086 services$0.14 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

5 suppliers46 claims46 services$188.43 avg. paid by Medicare

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738

DME-Oxygen and Supplies · category DC000N

1 supplier23 claims23 services$36.56 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

8 suppliers95 claims95 services$23.86 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

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

SAMANTHA JACKSON MD PLLC

Family Medicine

415 W FOREST LN
HOBART, OK 73651

Kiowa County (580) 726-2226

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 Samantha Jackson's NPI number?

The NPI number for Samantha Jackson is 1104806967. It was assigned to this individual provider in the NPPES registry on January 18, 2006.

Where is Samantha Jackson located?

Samantha Jackson practices at 415 W Forest Ln, Hobart, OK 73651. The listed phone number is (580) 726-2226.

What is Samantha Jackson's specialty?

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

Is Samantha Jackson enrolled in Medicare?

Yes. Samantha Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Does Samantha Jackson hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D1011307) is associated with this NPI, valid through April 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Samantha Jackson accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Samantha Jackson 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.

Is Samantha Jackson affiliated with any hospitals?

According to CMS data, Samantha Jackson is affiliated with Great Plains Regional Medical Center, Jackson County Memorial Hospital Authority, Weatherford Regional Hospital, Inc Of Weatherford and Cordell Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Samantha Jackson was last updated on September 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.

About Samantha Jackson Md NPPES

NPPES Registry Identity

Specialties & Licenses

Other Identifiers 1

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare Enrollment Status

CLIA Laboratory Certificates CMS CLIA

Certificate of Waiver · 37D1011307

Areas of Expertise CMS Part B claims 19

Hospital Affiliations CMS Care Compare 4

Great Plains Regional Medical Center

Jackson County Memorial Hospital Authority

Weatherford Regional Hospital, Inc Of Weatherford

Cordell Memorial Hospital

Physician Visit Costs CMS claims · ZIP area

Medicare Quality Performance CMS QPP · MIPS

Reported Quality Measures

Referred Medical Equipment & Supplies CMS DME claims 25

Other Providers at the Same Location NPPES

Frequently Asked Questions NPPES & CMS

What is Samantha Jackson's NPI number?

Where is Samantha Jackson located?

What is Samantha Jackson's specialty?

Is Samantha Jackson enrolled in Medicare?

Does Samantha Jackson hold a CLIA laboratory certificate?

What insurance does Samantha Jackson accept?

Is Samantha Jackson affiliated with any hospitals?

When was this NPI record last updated?

Certificate of Waiver 37D1011307