SAMANTHA JACKSON MD NPI 1104806967

NPI Details

Samantha Jackson, MD is a family medicine in Hobart, OK with 31 years of experience. The provider is 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. Samantha Jackson, MD NPI is 1104806967. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Graduation Year:1995

The provider's business location address is:

415 W FOREST LN
HOBART, OK
ZIP 73651-645
Phone: (580) 726-2226
Fax: (580) 726-8425

The NPI 1104806967 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 37D1011307 - physician office with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
• Follow-up nursing facility visit per day, typically 25 minutes (HCPCS:99309)
• Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
• Insertion of needle into vein for collection of blood sample (HCPCS:36415)
• Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic (HCPCS:G2012)
• Injection of drug or substance under skin or into muscle (HCPCS:96372)
• Injection, ketorolac tromethamine, per 15 mg (HCPCS:J1885)
• Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
• Injection, dexamethasone sodium phosphate, 1 mg (HCPCS:J1100)
• Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
• Administration of influenza virus vaccine (HCPCS:G0008)
• Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free (HCPCS:90674)
• Follow-up nursing facility visit per day, typically 15 minutes (HCPCS:99308)
• Hospital discharge day management, more than 30 minutes (HCPCS:99239)
• Initial hospital inpatient care per day, typically 50 minutes (HCPCS:99222)
• Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg (HCPCS:J3420)
• Urinalysis, manual test (HCPCS:81002)
• 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 (HCPCS:G0179)
• Initial nursing facility visit per day, typically 35 minutes (HCPCS:99305)
• 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 (HCPCS:G0180)
• Follow-up nursing facility visit per day, typically 25 minutes (HCPCS:99309)
• Initial nursing facility visit per day, typically 25 minutes (HCPCS:99304)
• Hospital observation care on day of discharge (HCPCS:99217)
• Initial hospital observation care per day, typically 50 minutes (HCPCS:99219)
• Nursing facility discharge management, more than 30 minutes (HCPCS:99316)

The enumeration date for this NPI number is 1/18/2006 and was last updated on 9/25/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.