Dawn Jackovich, MSN, FNP
Individual provider Active NPI Family Medicine Physician · Ishpeming, MI
NPI 1952166340 · NPPES record last updated Feb 15, 2024
Key facts
- NPI
- 1952166340
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 4704200910 (MI)
- Practice address
- 901 Lakeshore Dr
Ishpeming, MI 49849-1367 - Phone
- (906) 485-2858
- NPI assigned
- Feb 15, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bell Physician Practices Inc
Practice addresses (Care Compare)
901 Lakeshore Dr
Ishpeming, MI 49849-1367
Phone (906) 485-2687
Hospital & facility affiliations
- Bell Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240409003292 | MI | Practitioner - Nurse Practitioner | 8921446030 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704200910 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acquisition Bell Hospital LLC | Current |
Accepting new patients | |
| Acquisition Bell Hospital LLC | Current |
Accepting new patients | |
| Bell Physician Practices Inc | Current |
Accepting new patients | |
| Bell Physician Practices Inc | Family Medicine | Current |
Accepting new patients |
Locations
901 Lakeshore Dr
Ishpeming, MI 49849
Phone (906) 485-2653
330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780
Interoperability endpoints
- dawn.jackovich.1@8233.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4704200910 | MI | Yes |
Addresses
Primary practice location
901 Lakeshore Dr
Ishpeming, MI 49849-1367
Mailing address
145 Prospect St
Ishpeming, MI 49849-2623
Phone (906) 869-6584
Other providers in Ishpeming, MI
- Mary Hosking
- David Robert Huetter
- Natalie R Hutter
- Ishpeming Nursing & Rehab Center, LLC
- J P Lasich Chiropractic, LLC
- Luke Anthony Jacobson
- James E Frounfelter DDS PC
- Ninamarie Janofski
- Laura Jason
- Jean L Farbod DDS PLC
All providers in Ishpeming, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.