Julie W. Clark, MS, RD, LD, CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1002 Issued in IA

Practice address

106 W Washington St.
Jefferson, IA 50129-1920

Phone

(515) 386-4153

Fax

(515) 386-0364

NPI assigned

May 15, 2009

Last updated

May 8, 2015By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1242345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431043200000",
    "number": "1073748349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 W WASHINGTON ST.",
            "city": "JEFFERSON",
            "state": "IA",
            "postal_code": "501291920",
            "telephone_number": "515-386-4153",
            "fax_number": "515-386-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W WASHINGTON ST.",
            "city": "JEFFERSON",
            "state": "IA",
            "postal_code": "501291920",
            "telephone_number": "515-386-4153",
            "fax_number": "515-386-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JULIE",
        "middle_name": "W.",
        "credential": "MS, RD, LD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-15",
        "last_updated": "2015-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "1002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carroll Apothecary, Inc (Home Care Medical Equipment)
• Maribel Castellanos, FNP-C
• Centers for Long Term Care of Iowa (CLC Jefferson)
• Central Iowa Family Eyecare PLLC
• Columba Chukwubuikem Chukwuka, M.D
• Kristi Clark
• Laurie Lynn Connolly, M.D.
• County of Greene (Greene County Ambulance)
• Taylan Entriken
• Erica Erdahl

• Registered Dietitian in Jefferson, IA
• Providers in Jefferson, IA by specialty
• Registered Dietitian in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.