Custom Nutrition, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

CUSTOM NUTRITION, LLC

Practice address

12760 Stroh Ranch Way Ste 202
Parker, CO 80134-7507

Phone

(720) 531-3151

Fax

(720) 221-0657

NPI assigned

Oct 21, 2020

Organization subpart

No

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

Authorized official

Name

Christy Jean Beyerly, RDN, CDCES

Title

Registered Dietitian Nutritionist

Phone

(303) 358-3850

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1639778509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22416 QUAIL RUN LN",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388350",
            "telephone_number": "303-358-3850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12760 STROH RANCH WAY STE 202",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801347507",
            "telephone_number": "720-531-3151",
            "fax_number": "720-221-0657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-18",
        "status": "A",
        "authorized_official_last_name": "BEYERLY",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN NUTRITIONIST",
        "authorized_official_telephone_number": "303-358-3850",
        "authorized_official_credential": "RDN, CDCES"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colene Anne Cunningham, PHARMD
• Daniela Cunningham
• Emily Alice Cuomo, PA-C
• Sarah Anne Curtis, D.O.
• Cameron Cushing, CRC, LPC, NCC
• CVS Pharmacy Inc.
• CVS Pharmacy, Inc
• Kieva R D'Angelo
• Amy Dailey, CCC-SLP
• Kourtney N Dailey, MS, BCBA

• Registered Dietitian in Parker, CO
• Providers in Parker, CO by specialty
• Registered Dietitian in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.