DR. ROBERTA L JACKSON (NPI# 1295798866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295798866 |
| Entity Type | Individual |
| Full Name | DR. ROBERTA L JACKSON |
| Credential | M.D. |
| Practice Address |
842 E Main St Medford OR 97504-7134 |
| Practice Telephone | 5417732493 |
| Practice Fax Number | 5417793027 |
| Mailing Telephone | 5417732493 |
| Mailing Fax Number | 5417793027 |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2014-12-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD15832 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 055814 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457502346 | Roberta Ann Jackson | Massage Therapist | 294 Bay St, Taunton, MA 02780-1834 | 2008-10-09 |
| 1043232655 | Roberta D Jackson | Counselor | 2316 St Matthews Road, Orangeburg, SC 29118 | 2006-07-24 |
| 1760013353 | Roberta Marie Jackson | Social Worker | 123 W 124th St, New York, NY 10027-4920 | 2020-01-31 |
| 1073641213 | Roberta A Jackson | Speech-Language Pathologist | 310 N. Riverpoint Blvd, Box V, Spokane, WA 99202-1675 | 2007-03-01 |
| 1821145137 | Roberta Jackson | Social Worker | 2100 Bull St, Columbia, SC 29201-2104 | 2007-01-05 |
| Street Address |
842 E MAIN ST |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-7134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487647905 | James R Hills | Radiology | 842 E Main St, Medford, OR 97504-7134 | 2005-08-30 |
| 1326490269 | Tara Lynn Buck | Physician Assistant | 842 E Main St, Medford, OR 97504-7134 | 2016-07-04 |
| 1487023388 | Comprehensive Pain Care, LLC | Anesthesiology | 842 E Main St, Medford, OR 97504-7134 | 2015-09-21 |
| 1598102725 | Jonathan Frank Romero | Anesthesiology | 842 E Main St, Medford, OR 97504-7134 | 2013-05-29 |
| 1013352814 | Weston Jay Caywood | Radiology | 842 E Main St, Medford, OR 97504-7134 | 2013-05-07 |
| 1144663030 | Bryan Bret Clark | Anesthesiology | 842 E Main St, Medford, OR 97504-7134 | 2013-04-10 |
| 1477895704 | Seth Urban | Radiology | 842 E Main St, Medford, OR 97504 | 2013-03-25 |
| 1679815302 | Stacey Ann Wheeler | Physician Assistant | 842 E Main St, Medford, OR 97504-7134 | 2013-03-20 |
| 1699029298 | Chase Sagers Altom | Anesthesiology | 842 E Main St, Medford, OR 97504-7134 | 2012-11-04 |
| 1679825400 | Nathan Thomas Mortensen | Radiology | 842 E Main St, Medford, OR 97504 | 2012-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174765234 | Jeff Velez | Radiology | 64 Buzzells Ln, Medford, MA 02155-5932 | 2009-04-03 |
| 1164523312 | Paul Garrett | Radiology | 18 Fairview Rd, Medford, NJ 08055-9116 | 2006-09-26 |
| 1396857843 | Mid-island Medical Imaging, P.C. | Radiology | 1643c Route 112, Medford, NY 11763 | 2006-08-31 |
| 1558372706 | Sammy U Rehman | Radiology | 135 South Gibson Street, Medford, WI 54451-1622 | 2006-08-11 |
| 1336187608 | Hugh N Collier | Radiology | Lawrence Mem. Hospital, Dept. of Radiology, Medford, MA 02158 | 2006-06-02 |
| 1487647905 | James R Hills | Radiology | 842 E Main St, Medford, OR 97504-7134 | 2005-08-30 |
| 1679825400 | Nathan Thomas Mortensen | Radiology | 842 E Main St, Medford, OR 97504 | 2012-10-03 |
| 1598081028 | Rahim Fazel | Radiology | 881 Ohare Pkwy, Medford, OR 97504-4005 | 2010-04-08 |
| 1750525671 | Joseph Chisung Kim | Radiology | 842 E Main St, Medford, OR 97504-7134 | 2009-04-22 |
| 1952543373 | Zachary Rice Heeter | Radiology | 881 Ohare Pkwy, Medford, OR 97504-4005 | 2009-03-31 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.