Nisha Jackson PC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

NISHA JACKSON PC

Practice address

2590 Woodland Dr
Coos Bay, OR 97420-2050

Phone

(541) 217-2022

NPI assigned

Feb 12, 2026

Last updated

Jul 23, 2026By the provider in NPPES

Organization subpart

No

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

Addresses

Practitioners 1

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.

• Carrie Ellen Valle, FNP-C

  • Family Nurse Practitioner
  • Coos Bay, OR
  • NPI 1508589607
  NPD (past)

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": "1275485088",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2590 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202050",
            "telephone_number": "541-217-2022"
        }
    ],
    "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": []
}

• Thanh Tri Nguyen, PHARMD
• Jean Marie Nichols
• Nicole Hand-Therapeutic Massage
• Karen Louise Nielsen, LPC
• Agnes Kari Nilsen, PHARMACIST
• Stephanie R Nord
• North Bend Medical Center
• North Bend Medical Center Inc (NBMC-Xray Ekg)
• North Bend Medical Center Inc (NBMC-Day Surgery)
• North Bend Medical Center Inc (NBMC-Main)

• Rural Health Clinic/Center in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Rural Health Clinic/Center in Oregon

• 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.