Individual provider Active NPI

Alexandra Rae Cook, RDN

  • Registered Dietitian
  • Kalamazoo, MI
National Provider Identifier
1073982104
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86023853 Issued in MI
Practice address
1717 Shaffer St
Suite 108
Kalamazoo, MI 49048-1647
Phone
(269) 226-4909
NPI assigned
Sep 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86023853 MI Primary

Addresses

Primary practice location

1717 Shaffer St
Suite 108
Kalamazoo, MI 49048-1647

Mailing address

2950 Seymour Lake Rd
Ortonville, MI 48462-9166
Phone (269) 226-4909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86023853MIMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1073982104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 SEYMOUR LAKE RD",
            "city": "ORTONVILLE",
            "state": "MI",
            "postal_code": "484629166",
            "telephone_number": "269-226-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 SHAFFER ST",
            "address_2": "SUITE 108",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481647",
            "telephone_number": "269-226-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "ALEXANDRA",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-18",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "86023853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.