Marie K McClellan

Primary specialty

Health EducatorTaxonomy code 174H00000X

Practice address

401 Oldtowne St
Jacksonville, NC 28546-8066

Phone

(252) 626-3634

NPI assigned

May 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1982226916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 OLDTOWNE ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285468066",
            "telephone_number": "252-626-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 OLDTOWNE ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285468066",
            "telephone_number": "252-626-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "MARIE",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-13",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1083332375",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Smartphone",
            "affiliation": "N",
            "address_1": "401 Oldtowne St",
            "city": "Jacksonville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "285468066",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "address_1": "401 Oldtowne St",
            "city": "Jacksonville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "285468066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kali McCall
• Dale Calvin McCallister, LPCA
• Rachel McCarthy
• Samantha McCarthy
• Jennifer McClaney, FNP-C
• Dustin Lee McClinton, LMBT
• Patricia Ann McCloskey, OTR/L
• Amy Lee McComish, OTR/L
• Valynncia C McConnell
• Jenna McCormack, RBT

• Health Educator in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Health Educator in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; 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.