Dyan Marie Jacobson, PHYSICALTHERAPISTMPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6156 Issued in MN

Practice address

1620 17TH St NW
Faribault, MN 55021-2839

Phone

(507) 332-2204

Fax

(507) 332-2270

NPI assigned

Feb 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Potter Chiropractic

  • Chiropractor
  • Faribault, MN
  • NPI 1972734135
  NPD (past)
• Therapywerks PA

  • Physical Therapist
  • Faribault, MN
  • NPI 1760455588
  NPD (past)

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1457324253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 2ND ST NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559010360",
            "telephone_number": "507-288-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 17TH ST NW",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550212839",
            "telephone_number": "507-332-2204",
            "fax_number": "507-332-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "DYAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PHYSICALTHERAPISTMPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "6156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA IND PROVIDER #",
            "identifier": "6401148",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ IND PROVIDER #",
            "identifier": "2032898",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL PROVIDER#",
            "identifier": "33G05JA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS IND PRO#",
            "identifier": "HP42458",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U-CARE PROVIDER #",
            "identifier": "11613",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Iverson, PT
• J J Faribo Taxi
• J.O.Y. Senior Transportation LLC
• Miranda Jackson
• Katherine Marie Jacobs, OTR/L
• Paul Kenneth Jacobson, M.D.
• Sarah Ann Jentink
• Brenda J Jirik, LICSW
• Jaime Johns
• Daniel V Johnson, DDS

• Physical Therapist in Faribault, MN
• Providers in Faribault, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.