Sherwood Eric Jacobson

Primary specialty

DriverTaxonomy code 172A00000X

License

Q637137513216 Issued in MN

Practice address

606 Highway 123 W
Sandstone, MN 55072-5060

Phone

(320) 245-5355

Fax

(320) 216-7638

NPI assigned

Jul 4, 2023

Last updated

Jul 4, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

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  • Mental Health Counselor
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  • NPI 1376415935
  NPD

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

{
    "created_epoch": "1688428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688428800000",
    "number": "1407533110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26",
            "city": "SANDSTONE",
            "state": "MN",
            "postal_code": "550720026",
            "telephone_number": "320-245-5355",
            "fax_number": "320-216-7638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 HIGHWAY 123 W",
            "city": "SANDSTONE",
            "state": "MN",
            "postal_code": "550725060",
            "telephone_number": "320-245-5355",
            "fax_number": "320-216-7638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "SHERWOOD",
        "middle_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-04",
        "last_updated": "2023-07-04",
        "certification_date": "2023-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "MN",
            "license": "Q637137513216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Lynn Haverkamp
• Cynthia Herk, PHARM D
• Ashley Mae Nichole Herold, PHARMD
• David Lawrence Holm
• Cody Michael Huse
• Brent Merrill Jahnz
• Brianne Camilla Johnsen
• Kevin Mark Johnson
• Lowell Johnson
• Luann Johnson

• Driver in Sandstone, MN
• Providers in Sandstone, MN by specialty
• Driver in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 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.