# REILLY BEATTY SPORTS NUTRITION LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598624397
- **Authorized official:** REILLY BEATTY RD, MS, CSSD (REGISTERED DIETITIAN)
- **Authorized official phone:** (424) 346-3037

## Contact information

- **Practice address:** 728 SURREY PATH TRL, WINSTON SALEM, NC 27104-5035
- **Practice address phone:** (424) 346-3037
- **Mailing address:** 728 SURREY PATH TRL, WINSTON SALEM, NC 27104-5035

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133VN1501X | Sports Dietetics Nutrition Registered Dietitian | — | NULL | Yes |
| 133VN1501X | Sports Dietetics Nutrition Registered Dietitian | — | — | Yes |

## Other

- **Enumeration date:** 01/17/2026
- **Last updated:** 01/17/2026