Individual provider Active NPI

Paula L Clinton, DTR

  • Registered Dietetic Technician
  • Elizabeth, NJ
National Provider Identifier
1609945393
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Dietetic TechnicianTaxonomy code 136A00000X
Practice address
701 Newark Ave
Elizabeth, NJ 07208-3550
Phone
(908) 346-0269
NPI assigned
Nov 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietetic Technician 136A00000X Primary

Addresses

Primary practice location

701 Newark Ave
Elizabeth, NJ 07208-3550

Mailing address

111 Bermuda Dr
Branchburg, NJ 08853-4286
Phone (908) 336-0372

Other identifiers 1

IdentifierTypeStateIssuer
105846OtherNJAMERIGROUP PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060112000296 NJ Practitioner - Registered Dietitian Or Nutrition Professional 7618990946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Ludlow St
Newark, NJ 07114-1108
Phone (973) 565-0355

1150 Springfield Ave
Irvington, NJ 07111-2441
Phone (973) 399-6292

741 Broadway
Newark, NJ 07104-4309
Phone (973) 483-1300

751 Broadway
Newark, NJ 07104-4309
Phone (973) 483-1300

92 -96 Ferry St
Ironbound Medical and Dental Clinic
Newark, NJ 07104-4309
Phone (973) 803-4510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Newark Community Health Centers, Inc CurrentSince Dec 27, 2011 Accepting new patients
Newark Community Health Centers, Inc. CurrentSince Dec 27, 2011 Accepting new patients
Rekha Sharma MD PA PastSince Jun 1, 2004 Accepting new patients
Newark Community Health Centers Inc Past Accepting new patients

Locations

101 Ludlow St
Newark, NJ 07114
Phone (973) 565-0355

741 Broadway
Newark, NJ 07104
Phone (973) 483-1300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HBFIAA
  • Direct secure messaging: paula.clinton@nchc.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609945393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BERMUDA DR",
            "city": "BRANCHBURG",
            "state": "NJ",
            "postal_code": "088534286",
            "telephone_number": "908-336-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 NEWARK AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083550",
            "telephone_number": "908-346-0269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINTON",
        "first_name": "PAULA",
        "middle_name": "L",
        "credential": "DTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "136A00000X",
            "taxonomy_group": "",
            "desc": "Dietetic Technician, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PROVIDER #",
            "identifier": "105846",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.