Georgia Clark-Albert, MS RD LD CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI426 Issued in ME

Practice address

900 Broadway
BLDG 1
Bangor, ME 04401-1900

Phone

(207) 907-1187

Fax

(207) 907-1189

NPI assigned

Jan 14, 2010

Last updated

Jul 28, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Maniilaq Association

  dba Maniilaq Health Center

  • Rural Acute Care Hospital
  • Kotzebue, AK
  • NPI 1861698805

  TX

  Medicare reassignment
• Maniilaq Association

  dba Kiana Clinic

  • Federal Public Health Clinic/Center
  • Kiana, AK
  • NPI 1255608998
  NPD
• Maniilaq Association

  dba Maniilaq Health Center

  • Critical Access Hospital
  • Kotzebue, AK
  • NPI 1316995210
  NPD

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1740510759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 934",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044020934",
            "telephone_number": "207-907-1187",
            "fax_number": "207-907-1189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 BROADWAY",
            "address_2": "BLDG 1",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044011900",
            "telephone_number": "207-907-1187",
            "fax_number": "207-907-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK-ALBERT",
        "first_name": "GEORGIA",
        "credential": "MS RD LD CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-14",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ME",
            "license": "DI426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROGRAM",
            "identifier": "710000822",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Anthony Cirrinone, LCSW
• City of Bangor (Bangor Health & Community Services)
• City of Bangor (Bangor Fire Department)
• City of Bangor
• Charles A Civiello Jr., O.D.
• Kateryna Vadimovna Clark, M.S., R.D
• Peggy D Clark, SLP
• Tracey Durkovich Clark, DO
• James Lincoln Clarke, M.D.
• Classic Dentures of Maine

• Registered Dietitian in Bangor, ME
• Providers in Bangor, ME by specialty
• Registered Dietitian in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; 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.