Kelly Clark, MS, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

46 Mallards CV
Duxbury, MA 02332-3548

Phone

(781) 775-5994

NPI assigned

Nov 17, 2014

Last updated

Nov 17, 2014By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1356747448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 MALLARDS CV",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023323548",
            "telephone_number": "781-775-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 MALLARDS CV",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023323548",
            "telephone_number": "781-775-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KELLY",
        "credential": "MS, RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-17",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marisa Caissey Castanon, PT
• Aimee Chalifoux, LICSW
• Milton D Childress, M.D.
• Christine a. Hamori M.D. PC
• Adam Clark, M.ED., BCBA
• Coastal ABA
• Coastal Counseling
• Christine Alanna Cocchiaro, PA-C
• Contemporary Prosthodontics P.C.
• John G Cowl, MD

• Registered Dietitian in Duxbury, MA
• Providers in Duxbury, MA by specialty
• Registered Dietitian in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; 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.