Clean Slate Nutrition

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1005772 Issued in AR

Legal business name

CLEAN SLATE NUTRITION

Practice address

709 N Buchanan St
Little Rock, AR 72205-3264

Phone

(501) 580-0295

NPI assigned

Sep 1, 2015

Last updated

Sep 1, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Peggyc Cosgrove, MS, RD, LD

Title

Dietitian/Owner

Phone

(501) 580-0295

Specialties & licenses 1

Addresses

Other names 1

• Peggy Cosgrove, MS, RD, LD Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peggy Cosgrove, MS, RD, LD

  • Registered Dietitian
  • Little Rock, AR
  • NPI 1033591169

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441065600000",
    "number": "1619344157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 N BUCHANAN ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053264",
            "telephone_number": "501-580-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 N BUCHANAN ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053264",
            "telephone_number": "501-580-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAN SLATE NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-01",
        "last_updated": "2015-09-01",
        "status": "A",
        "authorized_official_last_name": "COSGROVE",
        "authorized_official_first_name": "PEGGYC",
        "authorized_official_title_or_position": "DIETITIAN/OWNER",
        "authorized_official_telephone_number": "501-580-0295",
        "authorized_official_credential": "MS, RD, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "AR",
            "license": "1005772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peggy Cosgrove, MS, RD, LD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nancy Clawitter, CRNA
• April Gentry Clawson, M.D.
• Marneica R Clay
• Kevin Douglas Claybrook, M.D.
• Kallie Clayton
• Clear Image, Inc. (Evans Vision Center)
• Clearview Digital Image LLC
• Clearview Digital Image LLC
• Donna Melissa Cleary, APN
• Rebecca Ann Cleary, PHARM.D.

• Registered Dietitian in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Registered Dietitian in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; 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.