Jacob Jay Dawson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

324142 Issued in WI

Practice address

5120 Stettin Dr
Wausau, WI 54401-3824

Phone

(715) 551-6827

NPI assigned

Sep 17, 2019

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1720638166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S 6TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014516",
            "telephone_number": "715-401-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 STETTIN DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013824",
            "telephone_number": "715-551-6827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "JACOB",
        "middle_name": "JAY",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-17",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "324142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David J. Aicher DDS SC
• David J. Wanserski, DDS, Ms, SC
• Andrew Brian Davis, MSPT LAT
• Barbara Davis, CADC III
• Rachel J. Davis, LPC-IT, SAC
• Jamie Elizabeth Dawson, RN
• Kenneth Lowell Day, M.D.
• Morgan Kristine Day, DC
• Mark W De Clute, MD
• Christian De Gregorio, MD

• Licensed Practical Nurse in Wausau, WI
• Providers in Wausau, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.