Ariel Petracca Selk, L.AC., DACM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

1602 Issued in MN

Practice address

14585 Grand Ave
Burnsville, MN 55306-5719

Phone

(952) 435-7349

Fax

(951) 417-6159

NPI assigned

Feb 9, 2015

Last updated

Jun 1, 2020By 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

Other names 1

• Ariel Petracca Former name

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": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1326439605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 WATERLOO AVE",
            "city": "SOUTH ST PAUL",
            "state": "MN",
            "postal_code": "550751050",
            "telephone_number": "808-321-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14585 GRAND AVE",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553065719",
            "telephone_number": "952-435-7349",
            "fax_number": "951-417-6159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14581 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553065714",
            "country_code": "US",
            "telephone_number": "952-435-7349",
            "fax_number": "952-417-6159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRACCA SELK",
        "first_name": "ARIEL",
        "name_prefix": "Dr.",
        "credential": "L.AC., DACM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-09",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ARIEL",
            "last_name": "PETRACCA",
            "credential": "L.AC.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; 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.