Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samuel Porter Jacks, MD

Individual provider Surgery Physician · NPI 1184828030

Samuel Porter Jacks, MD is a Thoracic Surgery in Winston Salem, North Carolina. Graduated from Wake Forest University School of Medicine in 2004, 22 years ago. Practices with Novant Health Medical Group, LLC, a 2,410-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
22
Trained at
Wake Forest University School of Medicine
Licensed in
NC
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4622 Country Club Rd Ste 180
Winston Salem, NC 27104-3769
Phone: (336) 768-9535
Fax: (336) 768-4155
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (primary) Taxonomy 208G00000X · Licence 2015-01953 (NC)
Surgery Physician Taxonomy 208600000X · Licence 2015-01953 (NC)

Record details

NPI number1184828030
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 13, 2007
Last updated in NPPESOctober 25, 2020
Certification dateSeptember 6, 2020

Medicare enrollment

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

Medicare specialtyTHORACIC SURGERY
Also practisesGENERAL SURGERY
Medical schoolWAKE FOREST UNIVERSITY SCHOOL OF MEDICINE
Graduated 2004 (22 years in practice)
Group practice Novant Health Medical Group, Llc — 2410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Winston Salem