Organization Active NPI

Peak Nutrition for Life LLC

  • Registered Dietitian
  • Apex, NC
National Provider Identifier
1194466243
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
PEAK NUTRITION FOR LIFE LLC
Practice address
101 Chilcott LN
Apex, NC 27502-4274
Phone
(919) 418-3332
NPI assigned
Apr 5, 2022
Organization subpart
Yes
Parent organization
PEAK NUTRITION FOR LIFE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Authorized official

Name
Theresa SaltsgaverNPI 1457022790
Title
RDN, LDN
Phone
(919) 418-3332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

101 Chilcott LN
Apex, NC 27502-4274

Mailing address

101 Chilcott LN
Apex, NC 27502-4274
Phone (919) 418-3332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220705000590 NC Part B Supplier - Clinic/Group Practice 6608256995 Receives reassigned benefits from 1 practitioner
Practice locations: Apex, NC

National Provider Directory

National Provider Directory
Part of
Peak Nutrition for Life LLC

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1194466243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CHILCOTT LN",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275024274",
            "telephone_number": "919-418-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CHILCOTT LN",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275024274",
            "telephone_number": "919-418-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK NUTRITION FOR LIFE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEAK NUTRITION FOR LIFE LLC",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-04",
        "status": "A",
        "authorized_official_last_name": "SALTSGAVER",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "RDN, LDN",
        "authorized_official_telephone_number": "919-418-3332"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apex, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.