Jessie Mae Jacobson, MS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

3635 Issued in MN

Practice address

1536 Hewitt Ave
Saint Paul, MN 55104-1205

Phone

(218) 409-8759

NPI assigned

May 13, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1669094538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7307 BRUNSWICK AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554432914",
            "telephone_number": "218-409-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 HEWITT AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041205",
            "telephone_number": "218-409-8759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "JESSIE",
        "middle_name": "MAE",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-13",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "3635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley Ann Jacobsma, R.N.
• Jacobson Woodworking & Remodeling LLC
• Amy Jacobson, PHN
• Carmen Jean Jacobson, P.A.-C
• Elizabeth Jacobson, CRNFA
• Joyce Jacobson, CRNA
• Kimberly A Jacobson, CPNP
• Jessica Jacovitch, MS, LPCC
• Elizabeth A Jacox, FNP-BC
• David D Jaeger, MD

• Athletic Trainer in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Athletic Trainer in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.