Donita J Clark, R.D., L.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

831 Issued in AR

Practice address

3 E Appleby Rd Ste 202
Fayetteville, AR 72703-4424

Phone

(479) 404-1140

Fax

(479) 404-1141

NPI assigned

Oct 28, 2008

Last updated

Oct 3, 2017By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Washington Regional Medical System

  dba Washington Regional Endocrinology

  • Endocrinology, Diabetes & Metabolism Physician
  • Fayetteville, AR
  • NPI 1255758868
  NPD
• Washington Regional Medical System

  dba Washington Regional Family Clinic - Farmington

  • Family Medicine Physician
  • Farmington, AR
  • NPI 1275839011
  NPD
• Washington Regional Medical System

  dba Washington Regional Family Clinic - Springdale

  • Family Medicine Physician
  • Springdale, AR
  • NPI 1326376419
  NPD
• Washington Regional Medical Center

  • General Acute Care Hospital
  • Fayetteville, AR
  • NPI 1083609150
  NPD (past)

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506988800000",
    "number": "1750534202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "72745",
            "telephone_number": "479-463-7775",
            "fax_number": "479-463-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 E APPLEBY RD STE 202",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034424",
            "telephone_number": "479-404-1140",
            "fax_number": "479-404-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DONITA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "R.D., L.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2017-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AR",
            "license": "831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Mikayla Clark, PA-C
• Brittany Clark
• Caitlin Clark
• Calvin Clark, LAC
• Christine R Clark, RD, LD, CDE
• Tiffany Clark
• William Taylor Clarke, DPT
• Meghan Clawson, MS, CCC-SLP
• David W Clay, MD
• Clear Vision Clinic PLLC

• Registered Dietitian in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Registered Dietitian in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2017; 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.