Active NPI
Lacey Funair, MS,RDN,CDCES,BC-ADM
- Registered Dietitian
- Zelienople, PA
National Provider Identifier
1811664915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN005678
- Practice address
- 405 Hazel St
Zelienople, PA 16063-1016 - Phone
- (724) 900-9075
- Fax
- (724) 382-7709
- NPI assigned
- Aug 26, 2021
- Last updated
- Jun 19, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DN005678 | PA | Primary |
| Specialist | 174400000X | CBDCE22200462 | ||
| Specialist | 174400000X | BCADM200914796 | ||
| Health Educator | 174H00000X |
Addresses
Primary practice location
405 Hazel St
Zelienople, PA 16063-1016
Mailing address
405 Hazel St
Zelienople, PA 16063-1016
Phone (724) 900-9075
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1039464260002 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diabetes Fundamentals LLC | Dietitian, Registered | Current | 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, 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": "1629936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718755200000",
"number": "1811664915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 HAZEL ST",
"city": "ZELIENOPLE",
"state": "PA",
"postal_code": "160631016",
"telephone_number": "724-900-9075",
"fax_number": "724-382-7709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 HAZEL ST",
"city": "ZELIENOPLE",
"state": "PA",
"postal_code": "160631016",
"telephone_number": "724-900-9075",
"fax_number": "724-382-7709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNAIR",
"first_name": "LACEY",
"credential": "MS,RDN,CDCES,BC-ADM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-26",
"last_updated": "2024-06-19",
"certification_date": "2024-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN005678",
"primary": true
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": "CBDCE22200462",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": "BCADM200914796",
"primary": false
},
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1039464260002",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Zelienople, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.