Carol O Clelland, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

353735 Issued in PA

Practice address

101 Washington St
Harrisburg, PA 17105-8700

Phone

(717) 221-6211

Fax

(717) 221-6266

NPI assigned

Jun 1, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1194762690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 WASHINGTON STREET",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WASHINGTON ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171058700",
            "telephone_number": "717-221-6211",
            "fax_number": "717-221-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLELLAND",
        "first_name": "CAROL",
        "middle_name": "O",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "PA",
            "license": "DN001038",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "353735",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN001038",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021058820001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gail Joan Nicole Baker Clark, BSBA, RDH, MS
• Jennifer Clark
• Rachel Claire Clark, L.S.W
• Nina Gogic Clay
• Amy E Cleck, CRNP
• Mary Ann Clement, CRNP
• Anna Clemente, LPC
• George Clements
• Renee Cless
• Amanda Cleveland, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; 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.