MEDICARE: DEE VEGGIE CHEF & RD, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1164257580
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEE VEGGIE CHEF & RD, LLC

Provider Business Mailing Address
First Line	:	1525 ENDERLY RD # 7
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28208-3341
Country	:	US
Telephone Number	:	980-203-3852
Fax Number	:

Provider Business Practice Location Address
First Line	:	1525 ENDERLY RD # 7
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28208-3341
Country	:	US
Telephone Number	:	980-203-3852
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DEMETRIA L COX-THOMAS
Credential	:	RDN, LDN
Telephone Number	:	980-203-3852

Provider Enumeration Date	:	09/05/2024
Last Update Date	:	04/21/2026

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