Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

NISHA JACKSON PC
NPI 1629920442
Clinic/Center - Rural Health in Roseburg, OR

Active since February 12, 2026
1700 NW GARDEN VALLEY BLVD STE 201, ROSEBURG, OR 97471(541) 930-8545 Get Directions Write a Review

NPPES record last updated: July 23, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Nisha Jackson Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NISHA JACKSON PC (NPI 1629920442) is a healthcare organization registered as a rural health in Roseburg, Oregon and active in the NPI registry since February 2026. The organization lists Karissa Stults, Vp Of Billing And Contracting, as its authorized official.

NPPES Registry Identity

NPI1629920442
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameNISHA JACKSON PC
Location Address1700 NW GARDEN VALLEY BLVD STE 201Roseburg, OR 97471-1636
Mailing Address2040 Commerce DrMedford, OR 97504-9744 · (541) 930-8545
Organization SubpartNo
Authorized OfficialKarissa StultsVp Of Billing And Contracting · (541) 930-8545
Enumeration DateFebruary 12, 2026
Last NPPES UpdateJuly 23, 2026
NPPES CertifiedJuly 23, 2026
NPI 1629920442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
1700 NW GARDEN VALLEY BLVD STE 201, Roseburg, OR 97471

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
1700 NW GARDEN VALLEY BLVD STE 201
ROSEBURG, OR 97471
Nurse Practitioner
1700 NW GARDEN VALLEY BLVD STE 201
ROSEBURG, OR 97471
Nurse Practitioner
1700 NW GARDEN VALLEY BLVD STE 201
ROSEBURG, OR 97471
Nurse Practitioner (Family)
1700 NW GARDEN VALLEY BLVD STE 201
ROSEBURG, OR 97471

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nisha Jackson PC's NPI number?

The NPI number for Nisha Jackson PC is 1629920442. It was assigned to this organization in the NPPES registry on February 12, 2026.

Where is Nisha Jackson PC located?

Nisha Jackson PC is located at 1700 NW Garden Valley Blvd Ste 201, Roseburg, OR 97471. The listed phone number is (541) 930-8545.

What is Nisha Jackson PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

When was this NPI record last updated?

The NPPES record for Nisha Jackson PC was last updated on July 23, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.