Casey Mortensen, RD, IBCLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1090229

Practice address

4765 N Grandview Peak Dr
Eagle Mountain, UT 84005-5440

Phone

(480) 393-9933

NPI assigned

Jun 28, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1669217774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4765 N GRANDVIEW PEAK DR",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840055440",
            "telephone_number": "480-393-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4765 N GRANDVIEW PEAK DR",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840055440",
            "telephone_number": "480-393-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "CASEY",
        "credential": "RD, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": "L-315224",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "1090229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Miller
• Loren D Mitchell, LPC
• Jonathan Mitton, DO
• Jared Moffett, CSW
• Madison Danielle Morgan, SLP
• Ruben Munoz, PTA
• Melanie Nielsen
• Hayley Nigbur, RDH, OMT
• Rachael Norene
• Jourdyn Marie Norton

• Registered Dietitian in Eagle Mountain, UT
• Providers in Eagle Mountain, UT by specialty
• Registered Dietitian in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.