Samantha Louise Jackson-Dilts, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D78881 Issued in MD

Practice address

2301A Forest Dr
Annapolis, MD 21401-3833

Phone

(410) 266-6767

Fax

(410) 266-6761

NPI assigned

May 27, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Dr. Samantha Louise Jackson Professional name

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mep Health, LLC

  • Emergency Medicine Physician
  • Rockville, MD
  • NPI 1164483558
  Medicare reassignment
• Summit Medical Group Arizona LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1053810622

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1821256801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOLLOW LN STE 301",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421215",
            "telephone_number": "516-207-7851",
            "fax_number": "516-207-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301A FOREST DR",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013833",
            "telephone_number": "410-266-6767",
            "fax_number": "410-266-6761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6358 Springfield Plz",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "VA",
            "postal_code": "221503431",
            "country_code": "US",
            "telephone_number": "703-644-5437",
            "fax_number": "703-644-6767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON-DILTS",
        "first_name": "SAMANTHA",
        "middle_name": "LOUISE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-27",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "61798",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "002952",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D78881",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101269251",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "JACKSON",
            "middle_name": "LOUISE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kavita Iyengar, MD
• J. Segal, MD, LLC
• J'Aime Nowell, LCSW-C, LLC
• Adeeb Jaber, MD
• Jack R Lichtenstein, MD LLC
• A'Neishia Jackson
• John D Jackson, MD
• Kai Love Jackson, BT, RPHT
• Kendra Lorraine Jackson, LPC
• Lauren Riley Jackson

• Pediatrics Physician in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.