KELLY MARIE CLARK (NPI# 1225552748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225552748 |
| Entity Type | Individual |
| Full Name | KELLY MARIE CLARK |
| Other Name | KELLY MARIE SCHIBI |
| Credential | RDN |
| Practice Address |
200 Mercy Circle Camp Pendleton CA 92055 |
| Practice Telephone | 7607193442 |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2017-07-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861026650 | Kelly Ann Clark | Nurse Practitioner | 4590 Childrens Pl, Saint Louis, MO 63110-1020 | 2020-03-02 |
| 1013474410 | Kelly Patricia Clark | Licensed Practical Nurse | 55 Pine Dr E, Mason, MI 48854-9229 | 2019-02-22 |
| 1013497304 | Kelly Ann Clark | Case Manager/Care Coordinator | 2498 Wenona Dr, Wixom, MI 48393-2199 | 2018-08-16 |
| 1407336720 | Kelly Elizabeth Clark | Physical Medicine & Rehabilitation | 3800 Reservoir Rd., Bles Building, Ground Floor, Department of Pm&r, Washington, DC 20007-2113 | 2018-08-16 |
| 1356747448 | Kelly Clark | Dietitian, Registered | 46 Mallards Cv, Duxbury, MA 02332-3548 | 2014-11-17 |
| 1568883312 | Kelly Clark | Licensed Practical Nurse | 125 W Bartlette St, Apt. 110, Sumter, SC 29150-5173 | 2013-12-20 |
| 1306105903 | Kelly Thomas Clark | Speech-Language Pathologist | 3406 Fowler Ct, Missouri City, TX 77459-6366 | 2012-05-16 |
| 1619247509 | Kelly Jane Clark | Pharmacist | 328 Quail Walk Trl, Chapin, SC 29036-9791 | 2012-01-09 |
| 1427350461 | Kelly Darlene Clark | Chiropractor | 2425 Mahan Dr, Tallahassee, FL 32308-2301 | 2010-11-24 |
| 1538479324 | Kelly S Clark | Licensed Vocational Nurse | 15716 W High St # 597, Middlefield, OH 44062-9201 | 2010-10-14 |
| Street Address |
200 MERCY CIRCLE |
| City | CAMP PENDLETON |
| State | CA |
| Zip Code | 92055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649255415 | Wayne Thomas Murphy | Preventive Medicine | 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2005-12-14 |
| 1679172621 | James Darko Ofori | Military Health Care Provider | 200 Mercy Circle, Pharmacy Department, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1194354662 | Melissa Bruebaker | Military Health Care Provider | 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2020-04-06 |
| 1891322269 | Pierce Derico | Student in an Organized Health Care Education/Training Program | 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2020-03-25 |
| 1871120774 | Rebeca Arias | Student in an Organized Health Care Education/Training Program | 200 Mercy Circle, Camp Pendleton, CA 92055 | 2020-03-23 |
| 1871128710 | Angela Christine Lacey | Student in an Organized Health Care Education/Training Program | 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2020-03-11 |
| 1447800727 | David Singleton | Dentist | 200 Mercy Circle, Camp Pendleton, CA 92055-6527 | 2019-09-18 |
| 1689233470 | Bryce Allen Bowers | Student in an Organized Health Care Education/Training Program | 200 Mercy Circle, Camp Pendleton, CA 92055 | 2019-06-06 |
| 1629636477 | Nikolas Brien Gutierrez | General Practice | 200 Mercy Circle, Camp Pendleton, CA 92055 | 2019-06-05 |
| 1518525369 | Elizabeth Helen Shields | Student in an Organized Health Care Education/Training Program | 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2019-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730755 | Zaccary Griffin | Military Health Care Provider | Building 4101 Stuart Mesa Rd, Camp Pendleton, CA 92055 | 2020-11-02 |
| 1194325597 | Connie Lim Good | Dental Hygienist | 14th Street Bldg 13128, Oceanside, CA 92055 | 2020-10-27 |
| 1386243327 | Leticia Isabel Alcantar | Dental Hygienist | Bldg 520448, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1548869571 | Joshua Watersjackson | Specialist/Technologist | 430406 Las Pulgas, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1235737164 | Tynesha Felice Calimquim | Dental Hygienist | Naval Hospital Camp Pendleton, Dental Department, 200 Mercy Circle, Oceanside, CA 92055 | 2020-10-13 |
| 1801494182 | Luis Alberto Necoechea | Military Health Care Provider | 1st Recon Bn Bas, Oceanside, CA 92055 | 2020-10-09 |
| 1689271603 | Lorena Santodomingo | Dental Hygienist | Bldg 210735 C Street, Camp Pendleton, CA 92055 | 2020-10-02 |
| 1720695984 | Douglas Thomas Duncan | Dental Assistant | 92055- 14th Strret, Oceanside, CA 92055 | 2020-09-30 |
| 1528675980 | Dora Louise Young | Dental Assistant | 92055 14th Street, Camp Pendleton, CA 92055 | 2020-09-29 |
| 1306453956 | Lynne Marie Reardon | Dental Hygienist | Bldg 310515, Camp Pendleton, CA 92055 | 2020-09-28 |
| Find all providers in zip 92055 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356333728 | Susan Steinman | Dietitian, Registered | Santa Margarita Rd Bldg H100, Attn: Code Cs-pa, Camp Pendleton, CA 92055 | 2005-08-22 |
| 1104337500 | Breanna Jean Butler | Dietitian, Registered | 200 Mercy Circle, Camp Pendleton, CA 92055 | 2017-10-12 |
| 1033481205 | Nicolette Catherine Bailey | Dietitian, Registered | H100 Santa Margarita Road, Attention: Code 094, Camp Pendleton, CA 92055-5191 | 2012-02-03 |
| 1528395936 | Amanda Morgan Strand | Dietitian, Registered | H100 Santa Margarita Road, Attention: Code 094, Camp Pendleton, CA 92055-5191 | 2009-11-05 |
| 1760505853 | Cari Jo Knudson | Dietitian, Registered | Naval Hospital, Camp Pendleton, H100 Santa Margarita Road, Camp Pendleton, CA 92055-5191 | 2007-04-06 |
| 1154482446 | Kimberly Marie Kauffman | Dietitian, Registered | Naval Hospital Camp Pendleton, Bldg H100 Santa Margarita, Camp Pendleton, CA 92055-5191 | 2006-12-12 |
| 1578565313 | Chris Lynn Noblit | Dietitian, Registered | Naval Hospital, Camp Pendleton, Bldg H100, Santa Margarita Road, Camp Pendleton, CA 92055-5191 | 2005-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083448 | Fuad Al Qudsi | Dietitian, Registered | 25874 Carmel Knolls Dr, Carmel, CA 93923-8830 | 2020-11-08 |
| 1700487535 | Katherine Zanville | Dietitian, Registered | 4928 Bellaire Ave, Valley Village, CA 91607-3419 | 2020-11-06 |
| 1760083711 | Gabriela E Zeagler | Dietitian, Registered | 1522 Halifax Way, El Dorado Hills, CA 95762-5841 | 2020-11-05 |
| 1427659796 | Yun Chieh Huang | Dietitian, Registered | 733 W Naomi Ave, Arcadia, CA 91007-7561 | 2020-11-03 |
| 1497356794 | Jelena Etemovic | Dietitian, Registered | 2517 S Alma St Apt 1, San Pedro, CA 90731-5738 | 2020-11-03 |
| 1588264337 | Apple Red Nutrition Services | Dietitian, Registered | 357 W. 2nd St, Suite #2, Loma Linda, CA 92354 | 2020-10-30 |
| 1912507708 | Eileen Hsiung | Dietitian, Registered | 830 Polaris Dr, Tustin, CA 92782-1720 | 2020-10-29 |
| 1912507831 | Aneeta Maria Vedula | Dietitian, Registered | 4371 Lombard Ave, Fremont, CA 94536-4929 | 2020-10-29 |
| 1336749449 | Sd Nutrition Group | Dietitian, Registered | 4295 Gesner St Ste 3a2, San Diego, CA 92117-6646 | 2020-10-28 |
| 1952901373 | Rubit Quintero-cobian | Dietitian, Registered | 3557 Willis Dr, Napa, CA 94558-2452 | 2020-10-26 |
| Find all providers with the same taxonomy | ||||
| City | CAMP PENDLETON |
| Zip Code | 92055 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.