Active NPI
Corinne L Clancy, RD
- Registered Dietitian
- Plymouth, MA
National Provider Identifier
1639146186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 334
- Practice address
- 46 Obery St
Plymouth, MA 02360-2237 - Phone
- (508) 210-5920
- NPI assigned
- Mar 3, 2006
- Last updated
- Dec 19, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 334 | MA | Primary |
Addresses
Primary practice location
46 Obery St
Plymouth, MA 02360-2237
Mailing address
46 Obery St
Plymouth, MA 02360-2237
Phone (508) 210-5920
Other practice location 1
570 Hawthorn St
North Dartmouth, MA 02747-3717
Phone (508) 996-3991
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 334 | MA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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": "1141344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576713600000",
"number": "1639146186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46 OBERY ST",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023602237",
"telephone_number": "508-210-5920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46 OBERY ST",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023602237",
"telephone_number": "508-210-5920"
}
],
"practiceLocations": [
{
"address_1": "570 Hawthorn St",
"address_purpose": "LOCATION",
"city": "North Dartmouth",
"state": "MA",
"postal_code": "027473717",
"country_code": "US",
"telephone_number": "508-996-3991",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLANCY",
"first_name": "CORINNE",
"middle_name": "L",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-03",
"last_updated": "2019-12-19",
"certification_date": "2019-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.