Active NPI
Kelly Brook Sinclair, MS, RD, CDE, LD
- Registered Dietitian
- Haverhill, MA
National Provider Identifier
1366687857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2082
- Practice address
- 1 Parkway
Haverhill, MA 01830-6278 - Phone
- (978) 521-3250
- Fax
- (978) 469-5646
- NPI assigned
- Dec 11, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DX2470 | MD | |
| Registered Dietitian | 133V00000X | 2082 | MA | Primary |
Addresses
Primary practice location
1 Parkway
Haverhill, MA 01830-6278
Mailing address
1 Parkway
Haverhill, MA 01830-6278
Phone (978) 521-3250
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2082 | MA | MD | Behavioral Analyst |
| DX2470 | MD | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331942400000",
"number": "1366687857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PARKWAY",
"city": "HAVERHILL",
"state": "MA",
"postal_code": "018306278",
"telephone_number": "978-521-3250",
"fax_number": "978-469-5646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PARKWAY",
"city": "HAVERHILL",
"state": "MA",
"postal_code": "018306278",
"telephone_number": "978-521-3250",
"fax_number": "978-469-5646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SINCLAIR",
"first_name": "KELLY",
"middle_name": "BROOK",
"credential": "MS, RD, CDE, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-11",
"last_updated": "2012-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MD",
"license": "DX2470",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "2082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Haverhill, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.