Nisha Jackson PC
NPI 1124499124ActiveOrganization· Nurse Practitioner· Medford, OR
Nurse Practitioner in Medford, Oregon, registered in NPPES in October 2015. The authorized official on file is Karissa Stults, Vp Of Billing And Contracting. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1124499124 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 15, 2015 |
| Last updated in NPPES | Jul 31, 2026 |
| Certified by provider | Jul 31, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 086006299N7 | OR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (OR) |
|---|
Other Nurse Practitioner providers in Medford
- 1285512798
- 1295484566
- 1336485846
- 1346849890
- 1780410316
- 1730018805
- 1346847332
- 1093724536
- 1750460416
- 1619045705
- 1790755031
- 1962601310