Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Dr. Kenneth Jake Sample, MD

Individual provider Internal Medicine Physician · NPI 1699358960

Dr. Kenneth Jake Sample, MD practises Internal Medicine in Gravette, Arkansas. Qualified in 2021, 5 years ago. Practices with Sgoh Acquisition Inc, a 93-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
5
Licensed in
AR
In the registry since
2021
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1101 Jackson St SW
Gravette, AR 72736-9121
Phone: (479) 787-5221
Fax: (479) 787-5613
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 346 N Main St, Decatur, AR 72722-9732 — (479) 752-3233
  • 920 Madison Ave Ste 447, Memphis, TN 38103-3438 — (901) 448-5814

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence E-18299 (AR)

Record details

NPI number1699358960
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 4, 2021
Last updated in NPPESAugust 5, 2024
Certification dateAugust 5, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Sgoh Acquisition Inc — 93 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Payments from drug and device companies, 2025

Drug and device makers are required by federal law (the Physician Payments Sunshine Act) to report what they pay or give to clinicians, and CMS publishes the reports as Open Payments. This is the 2025 program year. A report is a record of a payment, not an allegation of anything, and many are small items such as meals. Only general payments are listed here; research payments and ownership or investment interests are reported separately by CMS and are not shown.

Food and Beverage $74 3 payments · a meal or drink at a meeting or visit, not a fee

Each amount is the sum of what companies reported for that kind of payment in 2025, rounded to the dollar. Not all of it is income to the clinician: a meal is not a fee, a charitable contribution goes to a charity, and a royalty or an acquisition payment is not a salary.

Check a report, or dispute one, at the source in CMS’s own tool, Open Payments. Corrections go through CMS’s dispute process. This site removes a home address on request and asks for no proof, because that is privacy; it will not remove an accurate payment report on request, because that is a statutory public disclosure.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

Also affiliated with 1 nursing home, which CMS identifies by certification number only.

Colleagues at Sgoh Acquisition Inc

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 93 clinicians in the practice; 12 are shown here.

Other providers in Gravette