Active NPI
Edyth Layng McClure, R.D., C.D.E.
- Metabolic Nutrition Registered Dietitian
- Southbury, CT
National Provider Identifier
1437262102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Metabolic Nutrition Registered Dietitian
- Practice address
- 94 Fox Run Dr
Southbury, CT 06488-4408 - Phone
- (203) 267-4090
- Fax
- (203) 267-4057
- NPI assigned
- Aug 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Metabolic Nutrition Registered Dietitian | 133VN1006X | Primary |
Addresses
Primary practice location
94 Fox Run Dr
Southbury, CT 06488-4408
Mailing address
94 Fox Run Drive
Southbury, CT 06488
Phone (203) 267-4090
Other practice location 1
3150 Hugh Bennett Dr
Johns Island, SC 29455-3473
Phone (203) 586-9136
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050203000422 | CT | Practitioner - Registered Dietitian Or Nutrition Professional | 2062463334 | Practice locations: Southbury, CT |
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
94 Fox Run Dr
Southbury, CT 06488-4408
Phone (203) 267-4090
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000524 | CT | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708819200000",
"number": "1437262102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94 FOX RUN DRIVE",
"city": "SOUTHBURY",
"state": "CT",
"postal_code": "06488",
"telephone_number": "203-267-4090",
"fax_number": "203-267-4057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94 FOX RUN DR",
"city": "SOUTHBURY",
"state": "CT",
"postal_code": "064884408",
"telephone_number": "203-267-4090",
"fax_number": "203-267-4057"
}
],
"practiceLocations": [
{
"address_1": "3150 Hugh Bennett Dr",
"address_purpose": "LOCATION",
"city": "Johns Island",
"state": "SC",
"postal_code": "294553473",
"country_code": "US",
"telephone_number": "203-586-9136",
"fax_number": "203-267-4057",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCLURE",
"first_name": "EDYTH",
"middle_name": "LAYNG",
"name_prefix": "Ms.",
"credential": "R.D., C.D.E.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-16",
"last_updated": "2024-02-25",
"certification_date": "2024-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.