Amy Jacobson, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

591-156 Issued in WI

Practice address

1901 Beaser Ave
Ashland, WI 54806-3604

Phone

(715) 682-9311

Fax

(715) 682-9313

NPI assigned

Jun 5, 2014

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 WI, MI2 enrollments

Enrollment records 2

Specialty

Qualified Audiologist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Northern Lights Services, Inc.

  • Skilled Nursing Facility
  • Washburn, WI
  • NPI 1336198191

  Corporate Director, Managing Control - Governing Body

  CMS ownership

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

• Amy Jacobson LLC

  • Audiologist
  • Ashland, WI
  • NPI 1174107288

  Audiologist, MI, WI

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1134532245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 BEASER AVE",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548063604",
            "telephone_number": "715-682-9311",
            "fax_number": "715-682-9313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 BEASER AVE",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548063604",
            "telephone_number": "715-682-9311",
            "fax_number": "715-682-9313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11040 N State Road 77",
            "address_purpose": "LOCATION",
            "city": "Hayward",
            "state": "WI",
            "postal_code": "548433606",
            "country_code": "US",
            "telephone_number": "715-682-9311",
            "fax_number": "715-682-9313",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "N10565 Grandview Ln",
            "address_purpose": "LOCATION",
            "city": "Ironwood",
            "state": "MI",
            "postal_code": "499389622",
            "country_code": "US",
            "telephone_number": "715-682-9311",
            "fax_number": "715-682-9313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-05",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231HA2400X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": "WI",
            "license": "591-156",
            "primary": false
        },
        {
            "code": "231HA2500X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Supplier",
            "state": "WI",
            "license": "591-156",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WI",
            "license": "591-156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134532245",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy L Innes, PHARMD.
• John Douglas Ipsen
• Bradley C Irwin, MD
• J & C Stock SC
• Barry T Jacobs, DDS
• Michaelene Pheifer Jansen, RN, CNP
• Jacey Leann Janz Vernoski
• Kristine Marie Jensch, CAC.
• Jessica Ann Joanis, MSW
• Johnson Psychotherapy, LLC

• All providers in Ashland, WI
• Audiologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.