SAMANTHA ANN JACKSON N.P.
NPI 1770729535
Nurse Practitioner - Acute Care in Indianapolis, IN
About Samantha Ann Jackson N.p. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMANTHA ANN JACKSON N.P. (NPI 1770729535) is an individual acute care provider in Indianapolis, Indiana, licensed in Indiana (71002751A) and active in the NPI registry since December 2008. She is enrolled in Medicare PECOS, is affiliated with Community Hospital East, and is a graduate of Other (2008).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Samantha Ann Jackson N.p. 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.
Medicare Billing Reassignments
2Medicare enrollment records show Samantha Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Indianapolis, IN 46250
- Reassigned Medicare billing, Indiana enrollment
- 266 clinicians in this Medicare group
Indianapolis, IN 46256
- Reassigned Medicare billing, Indiana enrollment
- 2,087 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Community Hospital East
Acute Care Hospitals · Indianapolis, INPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 46250 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
INDIANAPOLIS, IN 46250
INDIANAPOLIS, IN 46250
INDIANAPOLIS, IN 46250
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 1770729535. It was assigned to this individual provider in the NPPES registry on December 29, 2008.
Where is Samantha Jackson located?
Samantha Jackson practices at 8075 N Shadeland Ave Suite 200, Indianapolis, IN 46250. The listed phone number is (317) 621-8500.
What is Samantha Jackson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.
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.
Which organizations bill Medicare for Samantha Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Jackson reassigns Medicare benefits to 2 organizations: Community Physician Network Specialty Care LLC (Indianapolis, IN) and Community Physicians Of Indiana Inc (Indianapolis, IN). Each 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 Samantha Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Samantha Jackson accept?
Health plans from Anthem Blue Cross and Blue Shield, CareSource and Cigna Healthcare 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 Community Hospital East.
When was this NPI record last updated?
The NPPES record for Samantha Jackson was last updated on June 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 Ann Jackson, N.P. · NPI 1770729535
Acute Care physician in Indianapolis, Indiana. Individual provider, active in the CMS NPPES registry since December 29, 2008.
## Identity
- **NPI:** 1770729535 (Entity type: Individual)
- **Enumerated:** December 29, 2008
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **State license:** 71002751A (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 8075 N SHADELAND AVE, SUITE 200, Indianapolis, IN 46250-2693
- **Phone:** (317) 621-8500 · **Fax:** (317) 621-8501
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Community Physician Network Specialty Care LLC (NPI 1588535496, Indianapolis, IN); Community Physicians Of Indiana Inc (NPI 1619105244, Indianapolis, IN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2008
## Record status
- **NPPES last updated:** June 11, 2021
- **Other identifiers:** Medicaid 200930050 (IN); Other P01235984 (IN)
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Source: [NPI Profile](https://npiprofile.com/npi/1770729535) · Data from the CMS NPPES public registry.