NPIMap

Organization Active NPI

Nisha Jackson PC

  • Rural Health Clinic/Center
  • McMinnville, OR
National Provider Identifier
1083566806
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
NISHA JACKSON PC
Practice address
235 SE Norton LN Ste C
McMinnville, OR 97128-8479
Phone
(503) 225-0382
NPI assigned
Feb 12, 2026
Last updated
Jul 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Karissa Stults
Title
VP of Billing and Contracting
Phone
(541) 930-8545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

235 SE Norton LN Ste C
McMinnville, OR 97128-8479

Mailing address

2040 Commerce Dr
Medford, OR 97504-9744
Phone (541) 930-8545

National Provider Directory

National Provider Directory
Tax ID family
Nisha Jackson Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

235 SE Norton Ln
Ste C
McMinnville, OR 97128
Phone (503) 225-0382

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1770854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784764800000",
    "number": "1083566806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 COMMERCE DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049744",
            "telephone_number": "541-930-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 SE NORTON LN STE C",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288479",
            "telephone_number": "503-225-0382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NISHA JACKSON PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-12",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A",
        "authorized_official_last_name": "STULTS",
        "authorized_official_first_name": "KARISSA",
        "authorized_official_title_or_position": "VP OF BILLING AND CONTRACTING",
        "authorized_official_telephone_number": "541-930-8545"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.