Individual provider Active NPI

Aleksandr V Gavrilov, RD, LDN

  • Registered Dietitian
  • Latrobe, PA
National Provider Identifier
1083592968
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN006973 Issued in PA
Practice address
1326 Waverly Dr
Latrobe, PA 15650-2636
Phone
(814) 279-1883
NPI assigned
Aug 26, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X DN006973 PA
Sports Dietetics Nutrition Registered Dietitian 133VN1501X DN006973 PA
Registered Dietitian 133V00000X DN006973 PA Primary

Addresses

Primary practice location

1326 Waverly Dr
Latrobe, PA 15650-2636

Mailing address

1326 Waverly Dr
Latrobe, PA 15650-2636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN006973PAMDObesity and Weight Management Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1083592968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 WAVERLY DR",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156502636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 WAVERLY DR",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156502636",
            "telephone_number": "814-279-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVRILOV",
        "first_name": "ALEKSANDR",
        "middle_name": "V",
        "credential": "RD, LDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-26",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "PA",
            "license": "DN006973",
            "primary": false
        },
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "PA",
            "license": "DN006973",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN006973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latrobe, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; 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.