Sheila Rae Jacobson, PT

Key facts

NPI

1700922796

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

03185 (IA)

Practice address

1028 Valley View Dr
Vermillion, SD 57069-3549

Phone

(605) 624-5690

NPI assigned

Jan 29, 2007

Sex

Female

Sole proprietor

Yes

Organizations & group practices 2

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.

• St Lukes Health Resources Family Medicine Physician · Sioux City, IA · NPI 1528001492
  NPD (past)
• St Lukes Health Resources Clinic/Center · Ponca, NE · NPI 1619932373
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700922796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 VALLEY VIEW DR",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570693549",
            "telephone_number": "605-624-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 VALLEY VIEW DR",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570693549",
            "telephone_number": "605-624-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "SHEILA",
        "middle_name": "RAE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Vermillion, SD · Physical Therapist in South Dakota