Emily M Jaksich, ARNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

202004567NP-PP Issued in OR

Practice address

3377 Riverbend Dr
Springfield, OR 97477-8803

Phone

(541) 222-8400

Fax

(541) 222-8401

NPI assigned

Oct 13, 2015

Last updated

Apr 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Peacehealth Medical GroupGroup PAC ID 9032023270, 256 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102
• Peace Harbor Medical Center Hospital, Florence, OR, CCN 381316
• Mercy Medical Center Hospital, Roseburg, OR, CCN 380027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peacehealth Medical Group

  • Family Medicine Physician
  • Eugene, OR
  • NPI 1447207287
  Medicare reassignment Care Compare group NPD
• Peacehealth

  dba Sacred Heart Physicians

  • Hospitalist Physician
  • Springfield, OR
  • NPI 1740223874

  Nurse Practitioner

  Medicare reassignment NPD
• Peacehealth Medical Group

  dba Nurse Midwifery Birth Center

  • Birthing Clinic/Center
  • Springfield, OR
  • NPI 1881860856
  NPD
• Neuropsychological Services of Oregon, LLC

  • Clinical Neuropsychologist
  • Creswell, OR
  • NPI 1164820478
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Commonspirit Oregon

  dba CHI Mercy Medical Center

  • General Acute Care Hospital
  • Roseburg, OR
  • NPI 1477590198
  Care Compare affiliation
• Peacehealth

  dba Sacred Heart-RiverBend

  • General Acute Care Hospital
  • Springfield, OR
  • NPI 1083888515
  Care Compare affiliation
• Peacehealth

  • Psychiatric Hospital Unit
  • Eugene, OR
  • NPI 1568236974
  Care Compare affiliation
• Peacehealth

  dba Peace Harbor Medical Center

  • Critical Access Hospital
  • Florence, OR
  • NPI 1578552402
  Care Compare affiliation

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1336510635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DRIVE",
            "address_2": "NEUROLOGY CLINIC",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "52240",
            "telephone_number": "319-353-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3377 RIVERBEND DR",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778803",
            "telephone_number": "541-222-8400",
            "fax_number": "541-222-8401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hayden Bridge Way",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974771347",
            "country_code": "US",
            "telephone_number": "541-868-9430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAKSICH",
        "first_name": "EMILY",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-13",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "202004567NP-PP",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IA",
            "license": "H124117",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "202004567NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R222420",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Makia Nicole Jackson, LPN
• Bianca Josienne Grecu Jacobs, M.D.
• Danielle Jacobs
• Cecelia Jacobson, REGISTERED DIETITIAN
• Anne T Jacques, MD
• David Francis Jamieson, MS, LPC
• Sarah Jane, RN, BSN
• Reed Casey Janke, PA-C
• Jason Paul Jarria, MD
• Michael D Jay, MD

• Acute Care Nurse Practitioner in Springfield, OR
• Providers in Springfield, OR by specialty
• Acute Care Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.