Margaret Jane Mall, RD LN BC-ADM CDE

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

License

425 Issued in MT

Practice address

1323 Bia Route 4
Fort Thompson, SD 57339-0200

Phone

(604) 245-1534

NPI assigned

Sep 22, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Jicarilla IHS Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Dulce, NM
  • NPI 1124220900
  NPD (past)
• US Dept of HHS

  • Clinic/Center
  • Lame Deer, MT
  • NPI 1053487991
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1609975721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200",
            "address_2": "1323 BIA ROUTE 4",
            "city": "FORT THOMPSON",
            "state": "SD",
            "postal_code": "573390200",
            "telephone_number": "604-245-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 BIA ROUTE 4",
            "city": "FORT THOMPSON",
            "state": "SD",
            "postal_code": "573390200",
            "telephone_number": "604-245-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALL",
        "first_name": "MARGARET",
        "middle_name": "JANE",
        "credential": "RD LN BC-ADM CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "MT",
            "license": "425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000K3526",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "HSZ196",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Xinyu Daniel Li, MD, PHD
• Bernard N Long, PT
• Lona Marie Longbrake, RN
• Sherry Lee Lulf, RN
• Jennifer Lynn Luper-Lark, ATC
• John L McFee Jr., MD
• Beth McPeak, RN
• Julie Kay Meintsma, RPH
• Sheila Fae Mines, RN
• Dianne Neyens

• Nutrition Education Nutritionist in Fort Thompson, SD
• Providers in Fort Thompson, SD by specialty
• Nutrition Education Nutritionist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.