Active NPI
Casey L Frederick, RDN, LD
- Registered Dietitian
- Broomfield, CO
National Provider Identifier
1063203271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86168424
- Practice address
- 13630 Via Varra Apt 223
Broomfield, CO 80020-9709 - Phone
- (812) 582-1093
- NPI assigned
- May 15, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86168424 | CO | Primary |
Addresses
Primary practice location
13630 Via Varra Apt 223
Broomfield, CO 80020-9709
Mailing address
13630 Via Varra Apt 223
Broomfield, CO 80020-9709
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260213001801 | OR | Practitioner - Registered Dietitian Or Nutrition Professional | 9931689593 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
13630 Via Varra Apt
Suite 223
Broomfield, CO 80020-9709
5021 Tualata LN
Lake Oswego, OR 97035-7116
9450 SW Gemini Dr
Beaverton, OR 97008-7105
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86168424 | CO | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Strategic Nutrition | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747267200000",
"number": "1063203271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13630 VIA VARRA APT 223",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800209709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13630 VIA VARRA APT 223",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800209709",
"telephone_number": "812-582-1093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICK",
"first_name": "CASEY",
"middle_name": "L",
"credential": "RDN, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-05-15",
"last_updated": "2025-05-15",
"certification_date": "2025-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CO",
"license": "86168424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; 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.