SAMANTHA JACKSON MD PLLC
NPI 1275973646
Family Medicine in Hobart, OK
About Samantha Jackson Md Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMANTHA JACKSON MD PLLC (NPI 1275973646) is a healthcare organization registered as a family medicine in Hobart, Oklahoma and active in the NPI registry since July 2013. The organization lists Samantha L Jackson, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Samantha Jackson Md Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Samantha Jackson MD PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 MD PLLC's NPI number?
The NPI number for Samantha Jackson MD PLLC is 1275973646. It was assigned to this organization in the NPPES registry on July 1, 2013.
Where is Samantha Jackson MD PLLC located?
Samantha Jackson MD PLLC is located at 415 W Forest Ln, Hobart, OK 73651. The listed phone number is (580) 726-2226.
What is Samantha Jackson MD PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Samantha Jackson MD PLLC enrolled in Medicare?
Yes. Samantha Jackson MD PLLC is registered in the Medicare PECOS enrollment system.
When is Samantha Jackson MD PLLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Oklahoma, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Samantha Jackson MD PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Samantha Jackson MD PLLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Samantha Jackson MD PLLC accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list Samantha Jackson MD PLLC 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 Samantha Jackson MD PLLC was last updated on January 16, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Samantha Jackson Md Pllc · NPI 1275973646
Family Medicine organization in Hobart, Oklahoma. Organization record, active in the CMS NPPES registry since July 1, 2013.
## Identity
- **NPI:** 1275973646 (Entity type: Organization)
- **Enumerated:** July 1, 2013
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** Yes (part of Samantha L Jackson Md)
- **Authorized official:** Samantha Jackson, OWNER
## Practice location
- **Address:** 415 W FOREST LN, Hobart, OK 73651-1645
- **Phone:** (580) 726-2226 · **Fax:** (580) 726-8425
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Oklahoma, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 16, 2017
- **Other identifiers:** Medicare PIN 318031YVNC (OK); Medicaid 200491840A (OK)
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Source: [NPI Profile](https://npiprofile.com/npi/1275973646) · Data from the CMS NPPES public registry.