Dawn Marie Jacobson, MD, MPH

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

68707 Issued in MN

Practice address

1687 Woodlane Dr
Woodbury, MN 55125-3045

Phone

(651) 600-3035

Fax

(651) 528-6149

NPI assigned

Apr 3, 2014

Reactivated

Feb 4, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2020 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ronald G Connolly MD

  • Rheumatology Physician
  • Walnut Creek, CA
  • NPI 1679641153
  NPD (past)

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1306264643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1687 WOODLANE DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253045",
            "telephone_number": "651-600-3035",
            "fax_number": "651-528-6149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1687 WOODLANE DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253045",
            "telephone_number": "651-600-3035",
            "fax_number": "651-528-6149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-03",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "deactivation_date": "2025-01-31",
        "reactivation_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "WA",
            "license": "MD61345049",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "A67499",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "ME",
            "license": "MD24527",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NJ",
            "license": "25MA11669200",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "MN",
            "license": "68707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shantara Alexandria Jackson
• Avery Jacobs
• Bennie Jacobs
• Carol K Jacobs, CPNP
• Kaile C Jacobs, OTD, OTR/L
• Nathan Jacobson
• Alisha Anne Jacoby, M.ED, BCBA
• Juan P Jaimes, M.D., M.S
• Lovette Teah Jalo
• Salma Jama

• Public Health & General Preventive Medicine Physician in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Public Health & General Preventive Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.