Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1699358960 Individual Practitioner Male Practitioner

Dr. Kenneth Jake Sample , MD

Internal Medicine • Gravette, AR

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Kenneth Sample, MD is a certified Internal Medicine practicing in Gravette, AR. With approximately 5 years of clinical experience since completing medical education in 2021, Dr. Sample delivers high-quality medical care to the local community at 1101 JACKSON ST SW.

Dr. Sample is affiliated with Sgoh Acquisition Inc and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

1101 Jackson St Sw

Gravette, AR 727369121

Telephone 4797875221
Fax 4797875613
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2021

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Gravette, AR

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
5 Yrs -0.5 yrs vs City Avg
City Avg: 5.5 Yrs
State Avg: 23.5 Yrs
Regional Practice Density
2 Specialists

Practicing in Gravette, AR (800 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Sample (5 Years) 5 Yrs
Gravette Specialty Average (5.5 Years) 5.5 Yrs

Medical Specialties & State Licenses

CMS Verified: 2024-08-05
Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License AR E-18299

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Hospital & Practice Group Affiliations

Sgoh Acquisition Inc

155 Village Dr, Sparta, MO 657538104

Phone: 4176344203

Sgoh Acquisition Inc

102 Russell Rd, Rogers, AR 727569319

Phone: 4792787189

Sgoh Acquisition Inc

346 N Main St, Decatur, AR 727229732

Phone: 4797523233

Sgoh Acquisition Inc

346 N Main St, Decatur, AR 727229732

Phone: 4797523233

Secondary Practice Locations

920 Madison Ave Ste 447

Memphis, TN 381033438

Phone: 9014485814

346 N Main St

Decatur, AR 727229732

Phone: 4797523233

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

15 Associated Practitioners
Dr. David Tucker , MD

Family Medicine

NPI 1023076619

Doctor of Medicine (M.D.)

Amelia Jackson , NP-C

Nurse Practitioner

NPI 1093105918

Nurse Practitioner (Certified)

Tamra Lamer , APRN

Nurse Practitioner - Psychiatric/Mental Health

NPI 1235494329

Advanced Practice Registered Nurse

Tammie Smith , ACNS-BC

Clinical Nurse Specialist

NPI 1255546974

ACNSBC

Dr. Nancy Jones , MD

Family Medicine

NPI 1346208527

Doctor of Medicine (M.D.)

Melody Walls , ACNP

Nurse Practitioner - Acute Care

NPI 1366537466

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location August 05, 2024

Registered at 1101 JACKSON ST SW, GRAVETTE, AR 727369121 (Tel: 4797875221)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 05, 2024

Internal Medicine (License #E-18299 in AR)

📍
Updated Business Mailing Address June 26, 2024

Registered at 1101 JACKSON ST SW, GRAVETTE, AR 727369121

NPI Profile Active May 04, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location May 04, 2021

Registered at 920 MADISON AVE STE 447, MEMPHIS, TN 381033438 (Tel: 9014485814)

📍
Updated Business Mailing Address May 04, 2021

Registered at 956 COURT AVE # H314, MEMPHIS, TN 381032814

👤
Provider Name / Credentials Updated May 04, 2021

Recorded as KENNETH SAMPLE, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 04, 2021

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 04, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1699358960
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 04, 2021
Last Update: August 05, 2024
Sole Proprietor: No

Mailing Address

1101 Jackson St Sw

Gravette, AR 727369121

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.