Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Johnny Phillip Payne, FNPDNP

Individual provider Nurse Practitioner · NPI 1962638452

Mr. Johnny Phillip Payne, FNPDNP is a Nurse Practitioner in Medford, Oregon. Qualified in 2012, 14 years ago. Practices with Nisha Jackson Inc, a 44-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
14
Licensed in
OR
In the registry since
2009
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Practice location Address checks out

2655 Siskiyou Blvd
Medford, OR 97504-8125
Phone: (541) 304-8008
Fax: (541) 612-3557
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 201250098NP (OR)

Record details

NPI number1962638452
Entity typeIndividual (Type 1)
GenderMale
Credentials FNPDNP
Sole proprietorNo
NPI enumeratedJune 10, 2009
Last updated in NPPESMarch 4, 2024
Certification dateMarch 4, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Nisha Jackson Inc — 44 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Medford