NPIMap

Individual provider Active NPI

Samantha Jackson, MD

  • Family Medicine Physician
  • Hobart, OK
National Provider Identifier
1104806967
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19876 Issued in OK
Practice address
415 W Forest LN
Hobart, OK 73651-1645
Phone
(580) 726-2226
Fax
(580) 726-8425
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19876 OK Primary

Addresses

Primary practice location

415 W Forest LN
Hobart, OK 73651-1645

Mailing address

PO Box 826
Hobart, OK 73651-0826
Phone (580) 726-2226

Other identifiers 1

IdentifierTypeStateIssuer
100131750DMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070926000847 OK Practitioner - Family Practice 7012002744 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

2230 N Perkins Rd
Stillwater, OK 74075-3076
Phone (405) 780-9919

415 W Forest LN
Hobart, OK 73651-1645
Phone (580) 726-2226

Hospital & facility affiliations

  • Angels Care Home Health of Oklahoma Home health agency, Oklahoma City, OK, CCN 377447
  • Enhabit Home Health of Western Oklahoma Home health agency, Weatherford, OK, CCN 377656
  • Elara Caring Xxiv Home health agency, Lawton, OK, CCN 377660
  • Sunshine Home Care, Inc Home health agency, Altus, OK, CCN 377487
  • Triad Home Health LLC Home health agency, Mangum, OK, CCN 377747
  • Good Shepherd Hospice, Inc. Hospice, Woodward, OK, CCN 371538
  • Traditions Health of Elk City Hospice, Elk City, OK, CCN 371583
  • Elk City Comforting Hands Hospice LLC Hospice, Elk City, OK, CCN 371698
  • Elkview General Hospital Hospital, Hobart, OK, CCN 370783
  • Cordell Memorial Hospital Hospital, Cordell, OK, CCN 371325
  • Jackson County Memorial Hospital Authority Hospital, Altus, OK, CCN 370022
  • Great Plains Regional Medical Center Hospital, Elk City, OK, CCN 370019
  • Weatherford Regional Hospital, Inc of Weatherford Hospital, Weatherford, OK, CCN 371323
  • Hobart Nursing & Rehabilitation Nursing home, Hobart, OK, CCN 375279
  • Cordell Nursing and Rehabilitation Nursing home, Cordell, OK, CCN 375306
  • Ayers Nursing Home Nursing home, Snyder, OK, CCN 375548

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as individual
Quality
83.67
Improvement activities
40
Cost
73.16

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19876OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samantha Jackson MD PLLC Family Medicine CurrentSince Aug 1, 2013 Accepting new patients
Kiowa County Hospital Authority CurrentSince Jan 1, 2017 Accepting new patients
Ayers Nursing Home Inc Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients
Cordell Memorial Hospital 0189 Past Accepting new patients
Southwest LTC - Hobart, LLC Past Accepting new patients
Cordell Nursing and Rehabilitation LLC Past Accepting new patients

Locations

415 W Forest Ln
Hobart, OK 73651
Phone (580) 726-2226

709 N Lowe St
Hobart, OK 73651
Phone (580) 224-0990

429 W Elm St
Hobart, OK 73651
Phone (580) 726-1900

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBHJCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/CBHJCD/Endpoint/CBHJCD

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1104806967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 826",
            "city": "HOBART",
            "state": "OK",
            "postal_code": "736510826",
            "telephone_number": "580-726-2226",
            "fax_number": "580-726-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W FOREST LN",
            "city": "HOBART",
            "state": "OK",
            "postal_code": "736511645",
            "telephone_number": "580-726-2226",
            "fax_number": "580-726-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SAMANTHA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "19876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100131750D",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hobart, OK

Sources for this page

Verify at the official NPI Registry.