Sally H Engebretson, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

43959 Issued in MN

Practice address

1421 Wayzata Blvd Ste 200
Wayzata, MN 55391-2071

Phone

(952) 592-4235

Fax

(952) 600-8461

NPI assigned

Apr 10, 2006

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

Other names 1

• Sally Jeannie Holmes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 2, 2023 through Oct 2, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1316900590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 WAYZATA BLVD STE 200",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553912071",
            "telephone_number": "952-592-4235",
            "fax_number": "952-600-8461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 WAYZATA BLVD STE 200",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553912071",
            "telephone_number": "952-592-4235",
            "fax_number": "952-600-8461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGEBRETSON",
        "first_name": "SALLY",
        "middle_name": "H",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "43959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "HOLMES",
            "middle_name": "JEANNIE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Scott Ellwanger, DC
• Ryan A Elton, DC
• Emma Nadler, L.L.C.
• Emma Nadler, L.L.C.
• Empowering You Mental Health, P.L.L.C.
• Baylee Engquist
• Episcopal Group Homes, Inc.
• Sarah Elizabeth Erwin, DPT
• Lucy B Esberg, MD
• Ever-Well Therapy Services

• Internal Medicine Physician in Wayzata, MN
• Providers in Wayzata, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.