Mackenzie Oltman, MS, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1360 Issued in ND

Practice address

801 Broadway N
Fargo, ND 58102-3641

Phone

(701) 234-2000

NPI assigned

Nov 10, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1639887441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023641",
            "telephone_number": "701-234-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLTMAN",
        "first_name": "MACKENZIE",
        "credential": "MS, RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "86103388",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ND",
            "license": "1360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "securerecords.sanford.html",
            "affiliation": "N",
            "endpointDescription": "Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5225 23rd Ave S",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581047927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephen Preston Olson, OTRL
• Sydney Mae Olson, DC
• Tammy Jo Olson, D.O
• Timothy Mark Olson I, D.C.
• Travis Lee Olson, D.D.S.
• Rachel Oluwaseunayo Olugbenga, FPA, FNP-BC, DNP.
• Oludamilola Wuraola Oluleye, M.D., M.P.H.
• Deeqa A Omar
• Firas Nidal Omar, RPH
• Admira Omerovic

• Registered Dietitian in Fargo, ND
• Providers in Fargo, ND by specialty
• Registered Dietitian in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.