Jill Marie Jacobson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

105112 Issued in MN

Practice address

150 Cobblestone LN
Burnsville, MN 55337-4578

Phone

(952) 460-4960

NPI assigned

Mar 16, 2016

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 names 1

• Jill Marie Sohre Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: jilljacobson@mklt.allscriptsdirect.net

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548374400000",
    "number": "1699136846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 COBBLESTONE LN",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374578",
            "telephone_number": "952-460-4960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 COBBLESTONE LN",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374578",
            "telephone_number": "952-460-4960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3305 Central Park Village Dr Ste 130",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551217707",
            "country_code": "US",
            "telephone_number": "952-460-4954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-16",
        "last_updated": "2019-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "105112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "SOHRE",
            "middle_name": "MARIE",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Siraad D Isse
• Kathleen Marie Ites
• J. Ellison and Associates, Inc.
• Jenna Christine Jablonski
• Emma Jacob
• Michele Leigh Jacobson, OTR/L
• Taylor Jacobson
• Tobias Carl Jacobson
• Connie Jaenicke, NP
• Rachel B Jallah

• Occupational Therapist in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; 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.