Active NPI
Vera Kotlyar, RD
- Registered Dietitian
- Apex, NC
National Provider Identifier
1396384343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L005851
- Practice address
- 2983 Farmhouse Dr
Apex, NC 27502-7060 - Phone
- (347) 967-6410
- NPI assigned
- Dec 21, 2019
- Last updated
- Mar 2, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | L005851 | NC | Primary |
Addresses
Primary practice location
2983 Farmhouse Dr
Apex, NC 27502-7060
Mailing address
2983 Farmhouse Dr
Apex, NC 27502-7060
Phone (347) 967-6410
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
200 Hawkins Ave
Suite 103D
Sanford, NC 27330-4324
Phone (347) 967-6410
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apex Functional Nutrition LLC | Dietitian, Registered | Current | Accepting new patients |
Locations
200 Hawkins Ave
Ste 103D
Sanford, NC 27330
Phone (347) 967-6410
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677715200000",
"number": "1396384343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2983 FARMHOUSE DR",
"city": "APEX",
"state": "NC",
"postal_code": "275027060",
"telephone_number": "347-967-6410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2983 FARMHOUSE DR",
"city": "APEX",
"state": "NC",
"postal_code": "275027060",
"telephone_number": "347-967-6410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTLYAR",
"first_name": "VERA",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-21",
"last_updated": "2023-03-02",
"certification_date": "2023-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L005851",
"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 Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.