Kristine Noel Clark, RD, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

117 Issued in WY

Practice address

1471 Dewar Dr # 204
Rock Springs, WY 82901-5814

Phone

(919) 564-9064

Fax

(307) 316-0228

NPI assigned

Jul 3, 2009

Last updated

Dec 12, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wellness Associates, LLC

  • Community/Behavioral Health Agency
  • Rock Springs, WY
  • NPI 1639547193
  NPD (past)

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

{
    "created_epoch": "1246579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1093944654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 ARROWHEAD CIR",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829017288",
            "telephone_number": "919-564-9064",
            "fax_number": "307-316-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1471 DEWAR DR # 204",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829015814",
            "telephone_number": "919-564-9064",
            "fax_number": "307-316-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KRISTINE",
        "middle_name": "NOEL",
        "name_prefix": "Mrs.",
        "credential": "RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-03",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WY",
            "license": "117",
            "primary": true
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "WY",
            "license": "117",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Christie
• Christopher Davidson, PC (Davidson Family Dental)
• Anna Chytka
• City of Rock Springs
• Christopher Tad Clark, M.ED.
• Augusta Clayton-Davis
• Allison Clemmer
• Kerry Francis Cobb
• Lindy Cobb, PCSW
• Amy Cobia

• Registered Dietitian in Rock Springs, WY
• Providers in Rock Springs, WY by specialty
• Registered Dietitian in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; 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.