Stacy Jo McClintic, MA, RD, CDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

001947-1 Issued in NY

Practice address

90 Presidential PLZ
Syracuse, NY 13202-2240

Phone

(315) 464-4219

Fax

(315) 464-4218

NPI assigned

Sep 30, 2016

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 names 1

• Ms. Stacy Jo Rosenberg Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1285183335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "address_2": "SUITE 2407",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-4304",
            "fax_number": "315-465-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 PRESIDENTIAL PLZ",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022240",
            "telephone_number": "315-464-4219",
            "fax_number": "315-464-4218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLINTIC",
        "first_name": "STACY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "MA, RD, CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-30",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "001947-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "ROSENBERG",
            "middle_name": "JO",
            "prefix": "MS.",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary P McCauley
• Ryanne Spencer McChesney
• Olivia Easton McCheyne
• Rachel McClean, LMT
• Amanda Ann McClellan
• Omar P McClinton
• Thomas Scott McCloughan, D.C.
• Barbara McClure, PH.D.
• Theresa A McConnell, LMSW
• Galen McCown, LCSW

• Registered Dietitian in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.