Michelle F Clark, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

006295 Issued in NY

Practice address

1425 Portland Ave
Rochester, NY 14621-3001

Phone

(585) 922-4000

NPI assigned

May 7, 2007

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

• Michelle F. Wegryn Former name

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1396958542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MICHELLE",
        "middle_name": "F",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "006295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "WEGRYN",
            "middle_name": "F.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Linda Levita Clark, M.D., M.S.
• Mary Louise Clark, OTR
• Maura Clark, RPH
• Megan Clark, P.A.
• Melissa Alexandria Clark, OTR/L, CLT
• Nancy S Clark, M.D.
• Nathan Clark, M.D.
• Pamela J Clark, A.N.P.
• Samantha Clark, RN
• Shabria Clark, LPN

• Registered Dietitian in Rochester, NY
• Providers in Rochester, 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 Feb 3, 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.