Andrea Witham (NPI# 1275982324, PAC ID# 5799067674) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
Nation Provider ID (NPI) | 1275982324 |
PAC ID by PECOS | 5799067674 |
Professional Enrollment ID | I20171228000352 |
Full Name | Andrea Witham |
Organization Legal Name | NISHA JACKSON INC. |
Address |
1700 Nw Garden Valley Blvd Suite 201 Roseburg OR 97471-1636 |
Phone Number | 5414640788 |
Gender | F |
Graduation Year | 2016 |
Primary Specialty | NURSE PRACTITIONER |
Group Practice PAC ID | 6305147745 |
Number of Group Practice Members | 12 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
380027 | MERCY MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
3265 Hillcrest Park Dr, Medford, OR 97504-7657 | 5414949355 | NISHA JACKSON INC. |
1700 Nw Garden Valley Blvd, Suite 201, Roseburg, OR 97471-1636 | 5414640788 | NISHA JACKSON INC. |
Organization Legal Name | NISHA JACKSON INC. |
Physicians | 12 |
Name | Specialty | Organization | Address |
---|---|---|---|
Kari Rocco | Nurse Practitioner | Nisha Jackson Inc. | 98 E 11th Ave, Eugene, OR 97401-3538 |
Christa Degrazia | Nurse Practitioner | Nisha Jackson Inc. | 3265 Hillcrest Park Dr, Medford, OR 97504-7657 |
Kimbra A Epps | Nurse Practitioner | Nisha Jackson Inc. | 1700 Nw Garden Valley Blvd, Suite 201, Roseburg, OR 97471-1636 |
Emily E Goemaat | Nurse Practitioner | Nisha Jackson Inc. | 3265 Hillcrest Park Dr, Medford, OR 97504-7657 |
Victoria D Deeks | Nurse Practitioner | Nisha Jackson Inc. | 1700 Nw Garden Valley Blvd, Suite 201, Roseburg, OR 97471-1636 |
Stephanie Patricia Romo | Nurse Practitioner | Nisha Jackson Inc. | 3265 Hillcrest Park Dr, Medford, OR 97504-7657 |
Mindy Lynn Leroy | Nurse Practitioner | Nisha Jackson Inc. | 3265 Hillcrest Park Dr, Medford, OR 97504-7657 |
Rebecca M Meek | Nurse Practitioner | Nisha Jackson Inc. | 3265 Hillcrest Park Dr, Medford, OR 97504-7657 |
Suzanne Tershak | Nurse Practitioner | Nisha Jackson Inc. | 1700 Nw Garden Valley Blvd, Suite 201, Roseburg, OR 97471-1636 |
Nisha M Jackson | Nurse Practitioner | Nisha Jackson Inc. | 1700 Nw Garden Valley Blvd, Suite 201, Roseburg, OR 97471-1636 |
Street Address |
1700 NW GARDEN VALLEY BLVD SUITE 201 |
City | ROSEBURG |
State | OR |
Zip | 97471-1636 |
Name | Specialty | Organization | Address |
---|---|---|---|
Kimbra A Epps | Nurse Practitioner | Nisha Jackson Inc. | 1700 Nw Garden Valley Blvd, Suite 201, Roseburg, OR 97471-1636 |
Victoria D Deeks | Nurse Practitioner | Nisha Jackson Inc. | 1700 Nw Garden Valley Blvd, Suite 201, Roseburg, OR 97471-1636 |
Suzanne Tershak | Nurse Practitioner | Nisha Jackson Inc. | 1700 Nw Garden Valley Blvd, Suite 201, Roseburg, OR 97471-1636 |
Nisha M Jackson | Nurse Practitioner | Nisha Jackson Inc. | 1700 Nw Garden Valley Blvd, Suite 201, Roseburg, OR 97471-1636 |
Name | Specialty | Organization | Address |
---|---|---|---|
Michael Brown | Radiation Oncology | Roseburg Oncology PC | 2880 Nw Stewart Pkwy, Suite 100, Roseburg, OR 97471-1201 |
Sylvia Gosline | Radiation Oncology | Roseburg Oncology PC | 2880 Nw Stewart Pkwy, Suite 100, Roseburg, OR 97471-1201 |
Randy L Moore | Radiation Oncology | Roseburg Oncology PC | 2880 Nw Stewart Pkwy, Suite 100, Roseburg, OR 97471-1201 |
Scott R Moore | Physician Assistant | Roseburg Oncology PC | 2880 Nw Stewart Pkwy, Roseburg, OR 97471-1201 |
Joshua Michael Weese | Hematology/oncology | Steelhead Specialty Group PC | 2880 Nw Stewart Pkwy, Suite 300, Roseburg, OR 97471-1205 |
Stephen A Williams | Hematology/oncology | Steelhead Specialty Group PC | 2880 Nw Stewart Pkwy, Suite 300, Roseburg, OR 97471-1205 |
Sara M Ray | Nurse Practitioner | Steelhead Specialty Group PC | 2880 Nw Stewart Pkwy, Suite 300, Roseburg, OR 97471-1205 |
Kurt A Brickner | Internal Medicine | Galen Inpatient Physicians Inc | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 |
Siobhan A Oreilly | Hospitalist | Galen Inpatient Physicians Inc | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 |
Subhajit Mukherjee | Gastroenterology | Centennial Medical Group Inc | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 |
Find all physicians in zip 97471 |
City | ROSEBURG |
Zip Code | 97471 |
Specialty | NURSE PRACTITIONER |
City + Specialty | ROSEBURG + NURSE PRACTITIONER |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.