Bernadette Clark, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DN001432 Issued in PA

Practice address

809 Turnpike Ave
Clearfield, PA 16830-1232

Phone

(814) 765-5341

Fax

(814) 768-2043

NPI assigned

Dec 3, 2014

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

Other identifiers 2

Other names 1

• Bernadette Marie Rudella Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1134526353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 TURNPIKE AVE",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168301232",
            "telephone_number": "814-342-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 TURNPIKE AVE",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168301232",
            "telephone_number": "814-765-5341",
            "fax_number": "814-768-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BERNADETTE",
        "credential": "LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-03",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN001432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED DIETICIAN ID NUMBER",
            "identifier": "495510",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "DN001432",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERNADETTE",
            "last_name": "RUDELLA",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gary Casteel, D.C.
• Keely Casteel, D.C.
• Erin Elizabeth Catherman, D.M.D.
• Jeremy Ryen Catherman, D.M.D.
• Damien P Charles, D.C.
• Gordon Penner Clark, M.D.
• Clear Care Corporation
• Clear Med Provider Corporation
• Clear Med Provider Corporation
• Clear Med Provider Corporation

• Registered Dietitian in Clearfield, PA
• Providers in Clearfield, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.