NPIMap

Individual provider Active NPI

Mackenzie Jane Wieser

  • Family Nurse Practitioner
  • Wahpeton, ND
National Provider Identifier
1972280550
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R44992 Issued in ND
Practice address
332 2ND Ave N
Wahpeton, ND 58075-4528
Phone
(701) 642-7000
NPI assigned
Jul 5, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 20

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center Fargo 1,210 clinicians
Sanford Health Network North 114 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

21 Wiley Ave S
Lidgerwood, ND 58053-4001
Phone (701) 538-4189

332 2ND Ave N
Wahpeton, ND 58075-4528
Phone (701) 642-7000

401 12TH St N
Wheaton, MN 56296-1070
Phone (320) 563-8971

Hospital & facility affiliations

  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Sanford Wheaton Medical Center Hospital, Wheaton, MN, CCN 241304
  • St Francis Medical Center Hospital, Breckenridge, MN, CCN 241377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND, SD3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Medicare enrollment records 3

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20230901000734 MN Practitioner - Nurse Practitioner 9234592627 Reassigns benefits to 1 organization
I20231023000423 ND Practitioner - Nurse Practitioner 9234592627 Reassigns benefits to 1 organization
I20241108003262 SD Practitioner - Nurse Practitioner 9234592627 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10503MNMDGeneral Practice Dentistry
R44992NDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Sep 9, 2023 Accepting new patients
Sanford Health Network North CurrentSince Aug 15, 2023 Accepting new patients
Sanford Health Network North CurrentSince Aug 15, 2023 Accepting new patients
Sanford Medical Center Fargo CurrentSince Sep 9, 2023 Accepting new patients
Coteau Des Prairies Hospital CurrentSince Sep 1, 2024 Accepting new patients
Coteau Des Prairies Hospital CurrentSince Sep 1, 2024 Accepting new patients
Sanford Health Network North Current Accepting new patients

Locations

1720 US Highway 59 SE
Thief Rvr Fls, MN 56701
Phone (218) 681-4747

401 12th St N
Wheaton, MN 56296
Phone (320) 563-8226

332 2nd Ave N
Wahpeton, ND 58075
Phone (701) 642-7000

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R44992 ND Primary

Addresses

NPPES NPI Registry

Primary practice location

332 2ND Ave N
Wahpeton, ND 58075-4528

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

205 Orchard Dr
Sisseton, SD 57262-2312
Phone (605) 698-4665

Other practice location 2

401 12th St N
Wheaton, MN 56296-1070
Phone (320) 563-8226

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 7, 2025.

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1972280550",
    "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": "332 2ND AVE N",
            "city": "WAHPETON",
            "state": "ND",
            "postal_code": "580754528",
            "telephone_number": "701-642-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Orchard Dr",
            "address_purpose": "LOCATION",
            "city": "Sisseton",
            "state": "SD",
            "postal_code": "572622312",
            "country_code": "US",
            "telephone_number": "605-698-4665",
            "fax_number": "605-698-6401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 12th St N",
            "address_purpose": "LOCATION",
            "city": "Wheaton",
            "state": "MN",
            "postal_code": "562961070",
            "country_code": "US",
            "telephone_number": "320-563-8226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIESER",
        "first_name": "MACKENZIE",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R44992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wahpeton, ND

Sources for this page

Verify at the official NPI Registry.