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Active NPI 1942580501 Individual Practitioner Male Practitioner

Clinton Harold Wattenberg , RD

Dietitian, Registered • Ithaca, NY

Professional Overview & Biography Verified Profile Summary

Clinton Wattenberg, RD is a registered healthcare professional specializing in Dietitian, Registered in Ithaca, NY. Practice services are available at 949 E STATE ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

949 E State St

Ithaca, NY 148506158

Telephone 6072279344

Specialty Benchmarks & Practice Insights

Comparative analytics for Dietitian, Registered in Ithaca, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 43.5 Yrs
State Avg: 17.7 Yrs
Regional Practice Density
29 Specialists

Practicing in Ithaca, NY (4786 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

State License NY 1044495

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Dietitian, Registered - Nutrition, Pediatric

NUCC Taxonomy Code: 133VN1004X

State License NY 1044495

An individual who is a Board Certified Specialist in Pediatric Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for pediatric patients. Specialists work directly with healthy and/or ill children (newborn up to 21 years of age) as well as children with special health care needs in a variety of settings (hospitals, community-based and/or family-centered programs, education programs, home, etc.), OR indirectly through management, care coordination, education, quality improvement, or research practice linked specifically to pediatric nutrition.

Dietitian, Registered - Nutrition, Metabolic

NUCC Taxonomy Code: 133VN1006X

State License NY 1044495

Definition to come...

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

State License NY 1044495

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active August 26, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location August 26, 2011

Registered at 949 E STATE ST, ITHACA, NY 148506158 (Tel: 6072279344)

📍
Updated Business Mailing Address August 26, 2011

Registered at 949 E STATE ST, ITHACA, NY 148506158 (Tel: 6072279344)

👤
Provider Name / Credentials Updated August 26, 2011

Recorded as CLINTON WATTENBERG, RD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 26, 2011

Dietitian, Registered (License #1044495 in NY)

🟢
Initial NPI Registration & Enumeration August 26, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1942580501
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 26, 2011
Last Update: August 26, 2011
Sole Proprietor: Yes

Mailing Address

949 E State St

Ithaca, NY 148506158

Phone: 6072279344

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.