NISHA JACKSON INC. (NPI# 1124499124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124499124 |
| Entity Type | Organization |
| Organization Name | NISHA JACKSON INC. |
| Practice Address |
3236 Hillcrest Park Dr Medford OR 97504-7657 |
| Practice Telephone | 5414949355 |
| Practice Fax Number | 5414940945 |
| Mailing Telephone | 5414949355 |
| Mailing Fax Number | 5414940945 |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2015-10-15 |
| Authorized Official Name | MS. NISHA MARIE JACKSON (OWNER/PRESIDENT) |
| Authorized Official Telephone | 5414949355 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
086006299N7 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 012158 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932656931 | Nisha Jackson Inc. | Nurse Practitioner | 2423 Nw Troost St, Roseburg, OR 97471-1706 | 2016-09-07 |
| Street Address |
3236 HILLCREST PARK DR |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-7657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 363LX0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Obstetrics & Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174634794 | Rebecca Rose | Nurse Practitioner | 221 W Stewart Ave Ste 101, Medford, OR 97501-3609 | 2006-08-31 |
| 1962462408 | Linda Kay Brouzes | Nurse Practitioner | 221 W Stewart Ave Ste 101, Medford, OR 97501-3609 | 2006-03-27 |
| 1316935455 | Mary Helen Darcy | Nurse Practitioner | 101 Main St, Suite 217, Medford, MA 02155-4540 | 2005-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780291146 | Menopause Northwest, LLC | Nurse Practitioner | 2712 Se 43rd Ave, Portland, OR 97206-1608 | 2020-09-29 |
| 1366951303 | Angelina Rene Skokan | Nurse Practitioner | 12220 Sw 1st St Ste 200, Beaverton, OR 97005-2890 | 2017-09-21 |
| 1023384062 | Cheri Maureen Monteith | Nurse Practitioner | 2460 Biehn Stree, Suite 1, Klamath Falls, OR 97601-1181 | 2012-03-23 |
| 1134242167 | Patricia M. Reddy | Nurse Practitioner | 560 Catalina Dr # 200, Ashland, OR 97520-1605 | 2007-04-06 |
| 1275611733 | Adria Yvonne Goodness | Nurse Practitioner | 833 S.w. 11th Ave., Suite 915, Portland, OR 97205 | 2006-11-01 |
| 1336169911 | Virginia Lois Capan | Nurse Practitioner | 3181 Sw Jackson Park Blvd, Oregon Health & Science University, Portland, OR 97239 | 2006-07-19 |
| 1487617502 | Melissa Sheffield | Nurse Practitioner | 1373 N 10th Ave, Stayton, OR 97383-2037 | 2006-04-10 |
| 1376504225 | Karen M Roberson | Nurse Practitioner | 1813 W. Harvard Ave., Suite 542, Roseburg, OR 97471-2752 | 2006-03-30 |
| 1801865738 | Emily S Downing - Moore | Nurse Practitioner | 353 Deadmond Ferry Rd, Springfield, OR 97477-9406 | 2006-03-14 |
| 1508482332 | Shannon Leigh Sluys | Nurse Practitioner | 2700 Se Stratus Ave, Mcminnville, OR 97128-6255 | 2020-06-17 |
| Find all providers with the same taxonomy | ||||
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| 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.