SAMUEL COLLINS JACKSON DPT
NPI 1811511199
Physical Therapist in Greenville, SC

Active since June 03, 2020Accepts Medicare Assignment
104 MAULDIN RD STE B, GREENVILLE, SC 29605(864) 214-6680(864) 309-8043 Get Directions Write a Review

NPPES record last updated: June 2, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 2, 2026, Oct 20, 2022, Oct 14, 2022 and 1 more (4 updates tracked since 2020).

About Samuel Collins Jackson Dpt NPPES

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

SAMUEL COLLINS JACKSON DPT (NPI 1811511199) is an individual physical therapist in Greenville, South Carolina, licensed in South Carolina (10222) and active in the NPI registry since June 2020. He is a graduate of Other (2020).

NPPES Registry Identity

NPI1811511199
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameSAMUEL COLLINS JACKSONCredential: DPT
Location Address104 MAULDIN RD STE BGreenville, SC 29605-1221
Mailing Address104 Mauldin Rd Ste BGreenville, SC 29605-1221 · (864) 214-6680 · Fax (864) 309-8043
Fax(864) 309-8043
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJune 3, 2020
Last NPPES UpdateJune 2, 20264 updates tracked since enumeration
NPPES CertifiedJune 2, 2026
NPI 1811511199 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License Licensed in SC · 10222
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
104 MAULDIN RD STE B, Greenville, SC 29605

Accepted 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

Samuel Collins Jackson Dpt 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 ID2163820481
PECOS Enrollment IDI20211018000258

Areas of Expertise CMS Part B claims 8

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.

Therapy procedure using functional activities 97530
A therapy procedure using functional activities encourages you to use your own body movements in day-to-day tasks to aid recovery. It aims to improve your mobility, strength, and overall health by incorporating therapeutic exercises into your routine.
358 services43 patients
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes 97112
This therapy helps retrain your brain, nerves, and muscles to work together. Through targeted exercises, your body learns to regain lost functions or improve current abilities. Each session lasts 15 minutes.
353 services40 patients
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110
This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.
307 services43 patients
Therapy procedure using manual technique, each 15 minutes 97140
This therapy involves using hands-on techniques to help improve your body's movement and function. These techniques may include stretching, resistance exercises, or gentle pressure. Each session lasts 15 minutes and aims to relieve pain, promote healing, and improve your overall health.
269 services42 patients
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care G0283
Electrical stimulation is a therapy method where mild electrical pulses are used to treat pain or stimulate muscles in certain areas. It's not for wound care but is part of a broader therapy plan. It's safe, non-invasive, and can help improve overall health.
93 services18 patients
Training for self-care or home management, each 15 minutes 97535
This service involves training sessions, each lasting 15 minutes, focused on teaching you essential self-care or home management skills. You'll learn techniques to manage your health condition at home, promoting independence and enhancing your quality of life.
68 services20 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29605 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
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$67.12 typical visit price
range $16.96 – $133.52
Typical copayment $16.78 (range $4.24 – $33.38)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

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

Clinic/Center (Physical Therapy)
104 MAULDIN RD STE B
GREENVILLE, SC 29605
Physical Therapist
104 MAULDIN RD STE B
GREENVILLE, SC 29605
Physical Therapist
104 MAULDIN RD STE B
GREENVILLE, SC 29605
Physical Therapist
104 MAULDIN RD STE B
GREENVILLE, SC 29605
Physical Therapist (Orthopedic)
104 MAULDIN RD STE B
GREENVILLE, SC 29605
Physical Therapist
104 MAULDIN RD STE B
GREENVILLE, SC 29605

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 Samuel Jackson's NPI number?

The NPI number for Samuel Jackson is 1811511199. It was assigned to this individual provider in the NPPES registry on June 3, 2020.

Where is Samuel Jackson located?

Samuel Jackson practices at 104 Mauldin Rd Ste B, Greenville, SC 29605. The listed phone number is (864) 214-6680.

What is Samuel Jackson's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Samuel Jackson enrolled in Medicare?

Yes. Samuel 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.

What insurance does Samuel Jackson accept?

Health plans from Molina Healthcare list Samuel 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.

When was this NPI record last updated?

The NPPES record for Samuel Jackson was last updated on June 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.