Apex Functional Nutrition LLC
Organization Active NPI Registered Dietitian · Sanford, NC
NPI 1558060178 · NPPES record last updated Aug 2, 2023
Key facts
- NPI
- 1558060178
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Registered Dietitian 133V00000X
- Legal business name
- APEX FUNCTIONAL NUTRITION LLC
- Practice address
- 200 Hawkins Ave Ste 103D
Sanford, NC 27330-4324 - Phone
- (347) 967-6410
- Fax
- (919) 578-4371
- NPI assigned
- Mar 2, 2023
- Organization subpart
- No
Authorized official
- Name
- Vera Kotlyar, RDN, LDN
- Title
- Dietitian
- Phone
- (347) 967-6410
Practitioners 1
-
Vera Kotlyar, RD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230517002178 | NC | Part B Supplier - Clinic/Group Practice | 1557727559 |
Receives reassigned benefits from 1 practitioner Practice locations: Sanford, NC |
National Provider Directory
Locations
200 Hawkins Ave
Ste 103D
Sanford, NC 27330
Phone (347) 967-6410
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian |
133V00000X | Yes |
Addresses
Primary practice location
200 Hawkins Ave Ste 103D
Sanford, NC 27330-4324
Mailing address
2983 Farmhouse Dr
Apex, NC 27502-7060
Phone (347) 967-6410
Other providers in Sanford, NC
- Daryl Lynn Ammons
- Sarah Amsley
- An&FC'S Residential Care
- April Dawn Anderson
- Antonio S. Braithwaite DDS MPH PA
- Wayne H Armstrong
- Katherine Ann Asadi
- Erica Elaine Asbury
- Ascend Leadership Academy Inc
- Behnam Asgharian
All providers in Sanford, NC · Registered Dietitian in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.