Lana Kalleen Clark, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

3281 Issued in MN

Practice address

2800 Cleveland Ave N
Roseville, MN 55113-1126

Phone

(651) 642-1825

NPI assigned

Nov 18, 2013

Last updated

Apr 26, 2018By 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

Other names 1

• Miss Lana Kalleen Hogan 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": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1427488048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 MANSON ST",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131029",
            "telephone_number": "612-289-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CLEVELAND AVE N",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131126",
            "telephone_number": "651-642-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LANA",
        "middle_name": "KALLEEN",
        "name_prefix": "Mrs.",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-18",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "3281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LANA",
            "last_name": "HOGAN",
            "middle_name": "KALLEEN",
            "prefix": "MISS",
            "credential": "RD, LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Dietitian in Roseville, MN
• Providers in Roseville, MN by specialty
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; 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.