This downloadable referral form is for your patient. You can also see all the nutrition-related diagnoses codes that may be able to help your patient qualify for nutrition therapy. To refer to us using your internal systems, you can find us on Leading Reach, Centricity, and others. If you prefer to fax this form to us as a referral for non-HMO, non-POS, and non-Medicare patients, our FAX NUMBER IS 800-888-9560. Our group NPI is 1518105857 and our main provider npi is 1144245309.
We like to share our SMARTS! As a complimentary service, we can provide nutrition in-service sessions to your medical office team.