Active NPI
Mackenzie Heisler, MS, RDN, LDN, CDN
- Registered Dietitian
- Ballston Spa, NY
National Provider Identifier
1831992205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 011964
- Practice address
- 87 Deer Run Dr
Ballston Spa, NY 12020-3048 - Phone
- (570) 225-5917
- NPI assigned
- Mar 31, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 011964 | NY | Primary |
| Registered Dietitian | 133V00000X | DN008133 | PA |
Addresses
Primary practice location
87 Deer Run Dr
Ballston Spa, NY 12020-3048
Mailing address
87 Deer Run Dr
Ballston Spa, NY 12020-3048
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011964 | NY | MD | Registered Dietitian |
| DN008133 | PA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743379200000",
"number": "1831992205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87 DEER RUN DR",
"city": "BALLSTON SPA",
"state": "NY",
"postal_code": "120203048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "87 DEER RUN DR",
"city": "BALLSTON SPA",
"state": "NY",
"postal_code": "120203048",
"telephone_number": "570-225-5917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEISLER",
"first_name": "MACKENZIE",
"credential": "MS, RDN, LDN, CDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-31",
"last_updated": "2025-03-31",
"certification_date": "2025-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "011964",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN008133",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ballston Spa, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.