Sara Ann Fetyko, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

1694 Issued in MN

Practice address

136 N 1St Ave E
Ely, MN 55731-1203

Phone

(612) 207-3660

Fax

(218) 242-8409

NPI assigned

Nov 8, 2013

Last updated

Dec 6, 2024By the provider in NPPES

Sex

Female

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Earth Elements Acupuncture & Wellness

  • Acupuncturist
  • Ely, MN
  • NPI 1063165843
  NPD Authorized official
• Blue Lotus Healing Arts, LLC

  dba Eastern Shore Natural Health

  • Acupuncturist
  • Minneapolis, MN
  • NPI 1346545449
  NPD (past)

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1255760336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 E WASHINGTON ST",
            "city": "ELY",
            "state": "MN",
            "postal_code": "557311707",
            "telephone_number": "612-207-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 N 1ST AVE E",
            "city": "ELY",
            "state": "MN",
            "postal_code": "557311203",
            "telephone_number": "612-207-3660",
            "fax_number": "218-242-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETYKO",
        "first_name": "SARA",
        "middle_name": "ANN",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ely-Bloomenson Community Hospital
• Ely-Bloomenson Community Hospital
• Ely-Bloomenson Community Hospital (Ely Community Pharmacy)
• Essentia Health Virginia, LLC (Essentia Health Ely Clinic)
• Essentia Health Virginia, LLC (Essentia Health Ely Clinic)
• Kim Noreen Garrett, APRN
• Healthy Families Chiropractic PLLC
• Allison Marie Heiman
• Scott Allen Hofstadter
• Julie Dawn Houle, MD

• Acupuncturist in Ely, MN
• Providers in Ely, MN by specialty
• Acupuncturist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.

Verify at the official NPI Registry.