Active NPI
Tatum Fjerstad, LAC
- Acupuncturist
- Minneapolis, MN
National Provider Identifier
1063090736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 1979
- Practice address
- 3011 36TH Ave S
Minneapolis, MN 55406-2796 - Phone
- (651) 767-2856
- NPI assigned
- Apr 1, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 1979 | MN | Primary |
Addresses
Primary practice location
3011 36TH Ave S
Minneapolis, MN 55406-2796
Mailing address
3034 37TH Ave S
Minneapolis, MN 55406-2133
Phone (651) 767-2856
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1979 | MN | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704326400000",
"number": "1063090736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3034 37TH AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554062133",
"telephone_number": "651-767-2856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3011 36TH AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554062796",
"telephone_number": "651-767-2856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FJERSTAD",
"first_name": "TATUM",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-01",
"last_updated": "2024-01-04",
"certification_date": "2024-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MN",
"license": "1979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.