MRS. PEGGY J MCCLELLAN (NPI# 1245273598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245273598 |
| Entity Type | Individual |
| Full Name | MRS. PEGGY J MCCLELLAN |
| Credential | DIETITAIN |
| Practice Address |
1034 N 500 W Provo UT 84604-3380 |
| Mailing Address |
Po Box 30180 Salt Lake City UT 84130-0180 |
| Practice Telephone | 8013737850 |
| Practice Fax Number | 8013577997 |
| Mailing Telephone | 8013577475 |
| Mailing Fax Number | 8013577997 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 1021324901 | UT | Dietary & Nutritional Service Providers |
| Street Address |
1034 N 500 W |
| City | PROVO |
| State | UT |
| Zip Code | 84604-3380 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780671453 | Marc Sune Robins | Family Medicine | 1034 N 500 W, Provo, UT 84604-3380 | 2005-09-28 |
| 1417562885 | Mckenzie Hamilton | Nurse Practitioner | 1034 N 500 W, Provo, UT 84604-3380 | 2020-09-13 |
| 1235741042 | Kristi Kay Anderson | Nurse Practitioner | 1034 N 500 W, Provo, UT 84604-3380 | 2020-08-21 |
| 1255968681 | Tiffani Petersen | Registered Nurse | 1034 N 500 W, Provo, UT 84604-3380 | 2020-03-25 |
| 1477188811 | Jodi Benson | Dietitian, Registered | 1034 N 500 W, Provo, UT 84604-3380 | 2020-03-05 |
| 1649815879 | Jessica Ricaurte | Nurse Practitioner | 1034 N 500 W, Provo, UT 84604-3380 | 2019-11-12 |
| 1174167795 | Courtney Danielle Akina | Speech-Language Pathologist | 1034 N 500 W, Provo, UT 84604-3337 | 2019-11-06 |
| 1396393609 | Camille Stanley | Speech-Language Pathologist | 1034 N 500 W, Provo, UT 84604-3380 | 2019-08-29 |
| 1386292076 | Rebecca Harris | Occupational Therapist | 1034 N 500 W, Provo, UT 84604-3380 | 2019-08-27 |
| 1770139289 | Cameron Lee Tingey | Nurse Practitioner | 1034 N 500 W, Provo, UT 84604-3380 | 2019-08-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
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| 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 |
|---|---|---|---|---|
| 1114554060 | Kristen Johnson | Dietitian, Registered | 395 W Cougar Blvd Ste 203, Provo, UT 84604-3328 | 2020-03-23 |
| 1225297419 | Mindy Crockett | Dietitian, Registered | 395 W Bulldog Blvd, Provo, UT 84604-3311 | 2008-06-03 |
| 1609067347 | Anna B Snyder | Dietitian, Registered | 1675 North Freedom Blvd Suite 15, Provo, UT 84604 | 2007-08-07 |
| 1477188811 | Jodi Benson | Dietitian, Registered | 1034 N 500 W, Provo, UT 84604-3380 | 2020-03-05 |
| 1588217038 | Anna-marie Ayotte | Dietitian, Registered | 1034 N 500 W, Provo, UT 84604-3380 | 2019-07-23 |
| 1770040263 | Jill Austad | Dietitian, Registered | 1034 N 500 W, Provo, UT 84604-3380 | 2019-02-21 |
| 1255805123 | Jillian Elaine Taylor Porto | Dietitian, Registered | 1034 N 500 W, Provo, UT 84604-3337 | 2019-01-14 |
| 1497249122 | Linda Griffiths Saxton | Dietitian, Registered | 306 River Bend Ln, Provo, UT 84604-5625 | 2018-06-16 |
| 1851802490 | Megan M. Kennedy | Dietitian, Registered | 1055 N 500 W Bldg A, Provo, UT 84604-3305 | 2017-10-23 |
| 1134647977 | Daniel Burgess | Dietitian, Registered | 1034 N 500 W, Provo, UT 84604-3380 | 2017-08-31 |
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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.