SAMANTHA ANN JACKSON (NPI# 1770729535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770729535 |
| Entity Type | Individual |
| Full Name | SAMANTHA ANN JACKSON |
| Credential | N.P. |
| Practice Address |
8075 N Shadeland Ave Suite 200 Indianapolis IN 46250-2693 |
| Mailing Address |
6626 E 75th St Ste 500 Indianapolis IN 46250-2805 |
| Practice Telephone | 3176218500 |
| Practice Fax Number | 3176218501 |
| Enumeration Date | 2008-12-29 |
| Last Update Date | 2018-10-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
71002751A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | MEDICARE RR PTAN | P01235984 | 01 |
| IN | 200930050 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649804360 | Samantha Jackson | Home Health Aide | 920 Waycross Rd, Cincinnati, OH 45240-3071 | 2020-03-03 |
| 1215408489 | Samantha Jackson | Licensed Vocational Nurse | 6100 Ashbury St Apt 3114, North Richland Hills, TX 76180-2010 | 2018-12-16 |
| 1861960221 | Samantha Rae Jackson | Nurse Practitioner | 320 Sumner Blvd, Collinsville, IL 62234-1929 | 2018-11-05 |
| 1104806967 | Samantha Jackson | Family Medicine | 415 W Forest Ln, Hobart, OK 73651-1645 | 2006-01-18 |
| 1710527387 | Samantha Jackson | Behavior Technician | 21230 Kingsland Blvd Ste 100a, Katy, TX 77450-5899 | 2020-01-13 |
| 1609438225 | Samantha Lachelle Jackson | Counselor | 1900 N Howard St Ste 300, Baltimore, MD 21218-5909 | 2019-07-03 |
| 1245607357 | Samantha Rae Jackson | Counselor | 695 South St, Chardon, OH 44024-1474 | 2015-08-24 |
| 1174906549 | Samantha L Jackson | Counselor | 1470 Civic Ct Ste 110, Concord, CA 94520-5290 | 2015-07-03 |
| 1558615583 | Samantha Jackson | Speech-Language Pathologist | 4609 San Dario Ave Ste 9, Laredo, TX 78041-5773 | 2012-10-29 |
| 1801191754 | Samantha Jackson | Physician Assistant | 1818 Richardson Dr, Reidsville, NC 27320-5451 | 2011-01-24 |
| Street Address |
8075 N SHADELAND AVE SUITE 200 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46250-2693 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922005289 | Angela Kaye Unfried | Physician Assistant | 8075 N Shadeland Ave, Suite 120, Indianapolis, IN 46250-2693 | 2005-07-01 |
| 1780158352 | Kay Ellen Simon | Nurse Practitioner | 8075 N Shadeland Ave, Indianapolis, IN 46250-2693 | 2019-01-17 |
| 1831667823 | Jaswinder Jalf | Nurse Practitioner | 8075 N Shadeland Ave, Indianapolis, IN 46250-2693 | 2018-11-07 |
| 1588130108 | Diane Marie Doty | Clinical Nurse Specialist | 8075 N Shadeland Ave, Indianapolis, IN 46250-2693 | 2018-10-22 |
| 1457887622 | Kelly Ann Lowe | Registered Nurse | 8075 N Shadeland Ave, Indianapolis, IN 46250-2693 | 2017-05-10 |
| 1548713290 | Lacey Keller | Registered Nurse | 8075 N Shadeland Ave, Ste 200, Indianapolis, IN 46250-2693 | 2016-07-29 |
| 1326480948 | Kelly L Warren | Registered Nurse | 8075 N Shadeland Ave, Suite 200, Indianapolis, IN 46250-2693 | 2013-07-24 |
| 1780025247 | Community Health Network | General Acute Care Hospital | 8075 N Shadeland Ave, Indianapolis, IN 46250-2693 | 2013-07-12 |
| 1780021758 | Kendra Marie Storer | Registered Nurse | 8075 N Shadeland Ave, Suite 200, Indianapolis, IN 46250-2693 | 2013-05-30 |
| 1356787493 | Jennifer Ruth Heisick | Nurse Practitioner | 8075 N Shadeland Ave, Suite 200, Indianapolis, IN 46250-2693 | 2013-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861037004 | Angela L Davis | Pharmacist | 8520 Bash St, Indianapolis, IN 46250 | 2019-11-12 |
| 1710455738 | Physicians Wellness Associates LLC | Family Medicine | 4735 Statesmen Drive, Suite C, Indianapolis, IN 46250 | 2018-11-07 |
| 1891222584 | Confidential Drug LLC | Pharmacy | 8520 Bash St Ste D, Indianapolis, IN 46250 | 2017-05-12 |
| 1659813590 | Occupational Health Centers of The Southwest Pa | Clinic/Center | 8257 Center Run Rd, Indianapolis, IN 46250 | 2016-11-09 |
| 1194275669 | Lucina Treatment Center, LLC | Internal Medicine | 8140 Castleton Rd, Indianapolis, IN 46250 | 2016-10-09 |
| 1609126150 | Joseph Lee Deck | Physical Therapist | 7400 Jewel Lane, Indianapolis, IN 46250 | 2012-09-12 |
| 1447508254 | Choices Coordinated Care Solutions, Inc. | Clinic/Center | 7941 Castleway Drive, Indianapolis, IN 46250 | 2012-08-28 |
| 1568719854 | Lynda L. Blackwelder, LLC | Marriage & Family Therapist | 4735 Statesmen Dr., Suite A, Indianapolis, IN 46250 | 2012-08-06 |
| 1972859452 | Courtney B. Cortez | Nurse Practitioner | 12400 N Meridian Ste 100, Suite 500, Indianapolis, IN 46250 | 2012-08-02 |
| 1861761934 | Kb Medical, Inc. | Durable Medical Equipment & Medical Supplies | 8455, Castlewood Drive, Suite J, Idianapolis, IN 46250 | 2011-12-20 |
| Find all providers in zip 46250 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326683210 | Lindsay Nicole Rich | Nurse Practitioner | 1800 N Senate Ave, Indianapolis, IN 46202 | 2019-11-14 |
| 1780160069 | Cara Crone | Nurse Practitioner | 8402 Harcourt Rd Ste 500, Indianapolis, IN 46260-2054 | 2018-07-19 |
| 1689129645 | Casie Stevens | Nurse Practitioner | 1701 Senate Blvd Ste 238, Indianapolis, IN 46202-1239 | 2016-08-19 |
| 1548611346 | Jenna N Treadwell | Nurse Practitioner | 1801 N Senate Blvd Ste 230, Indianapolis, IN 46202-1252 | 2016-06-23 |
| 1073627865 | Connie Lynn Allen | Nurse Practitioner | 5940 Decatur Blvd, Indianapolis, IN 46241-9579 | 2006-08-18 |
| 1881209294 | Jennifer L Maupin | Nurse Practitioner | 2001 W 86th St, Indianapolis, IN 46260-1902 | 2020-09-11 |
| 1881207686 | Mary Anjanette Romer | Nurse Practitioner | 720 Eskenazi Ave, Indianapolis, IN 46202-5187 | 2020-08-31 |
| 1508475526 | Wade Everett Oliver | Nurse Practitioner | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-07-27 |
| 1538778600 | Marleana Leann Groh | Nurse Practitioner | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-07-24 |
| 1093331084 | Katherine Leigh Walker | Nurse Practitioner | 550 University Blvd Ste 6100, Indianapolis, IN 46202-5149 | 2020-06-25 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46250 |
Please comment or provide details below to improve the information on SAMANTHA ANN JACKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.