Individual provider Active NPI

Dawn Marie Jacobson, RN

  • Hospice Registered Nurse
  • Sierra Vista, AZ
National Provider Identifier
1073380937
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice Registered NurseTaxonomy code 163WH1000X
License
RN196043 Issued in AZ
Practice address
4066 E Monsanto Dr Unit E
Sierra Vista, AZ 85650-8512
Phone
(520) 335-6118
Fax
(888) 504-1425
NPI assigned
Dec 11, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice Registered Nurse 163WH1000X RN196043 AZ Primary

Addresses

Primary practice location

4066 E Monsanto Dr Unit E
Sierra Vista, AZ 85650-8512

Mailing address

4901 E Bevers St
Sierra Vista, AZ 85650-9430
Phone (719) 680-9047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN196043AZMDHospice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1073380937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 E BEVERS ST",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856509430",
            "telephone_number": "719-680-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4066 E MONSANTO DR UNIT E",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856508512",
            "telephone_number": "520-335-6118",
            "fax_number": "888-504-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "AZ",
            "license": "RN196043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.