Brooke Leigh Fredrickson, LRD, CSG

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

669 Issued in ND

Practice address

1200 Roberts Ave NE
Cooperstown, ND 58425-7101

Phone

(701) 797-2221

NPI assigned

Sep 18, 2009

Last updated

Sep 18, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Group practices

Valley Christian Counseling Center IncGroup PAC ID 6709845654, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brookefredrickson@normd.allscriptsdirect.net

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.

• Valley Christian Counseling and Wellness

  • Professional Counselor
  • Fargo, ND
  • NPI 1467559427

  Dietitian, Registered

  Medicare reassignment Care Compare group NPD
• Carrington Health Center

  dba CHI St. Alexius Health Carrington

  • Critical Access Hospital
  • Carrington, ND
  • NPI 1205807013
  Medicare reassignment NPD
• Carrington Health Center

  dba CHI St. Alexius Health Carrington Medical Clinic & Urgent Care

  • Rural Health Clinic/Center
  • Carrington, ND
  • NPI 1558389338
  Medicare reassignment
• Carrington Health Center

  dba CHI St. Alexius Health Carrington Family Clinic

  • Rural Health Clinic/Center
  • New Rockford, ND
  • NPI 1801811666
  NPD
• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1253232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253232000000",
    "number": "1053645317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 COUNTY ROAD 19",
            "city": "COOPERSTOWN",
            "state": "ND",
            "postal_code": "584259168",
            "telephone_number": "701-361-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ROBERTS AVE NE",
            "city": "COOPERSTOWN",
            "state": "ND",
            "postal_code": "584257101",
            "telephone_number": "701-797-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKSON",
        "first_name": "BROOKE",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "LRD, CSG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-18",
        "last_updated": "2009-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ND",
            "license": "669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cooperstown Medical Center (Cooperstown Medical Center Nursing Home)
• Cooperstown Medical Center (Cooperstown Medical Center Swing Bed)
• Cooperstown Medical Center (CMC Rural Health Clinic)
• Rachel Marie Dahl, PHARM D
• Essential Chiropractic PLLC (Essential Chiropractic)
• Griggs County
• Griggs County Nursing Home (Griggs County Care Center)
• Cia Gronneberg
• Kevin S Jacobson, NP
• Annette Robin Krabbenhoft

• Registered Dietitian in Cooperstown, ND
• Providers in Cooperstown, ND by specialty
• Registered Dietitian in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.