Active NPI
Andrea L Cooper, RD LD/N
- Registered Dietitian
- Jensen Beach, FL
National Provider Identifier
1275859878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND4025
- Practice address
- 3496 NW Federal Hwy
Ste F
Jensen Beach, FL 34957-4441 - Phone
- (772) 223-4916
- Fax
- (772) 223-2887
- NPI assigned
- Apr 8, 2010
- Last updated
- Apr 22, 2025
- Sex
- Female
- Sole proprietor
- No
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 | ND4025 | FL | Primary |
Addresses
Primary practice location
3496 NW Federal Hwy
Ste F
Jensen Beach, FL 34957-4441
Mailing address
PO Box 9033
Stuart, FL 34995-9033
Phone (772) 223-4916
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100524000640 | FL | Practitioner - Registered Dietitian Or Nutrition Professional | 2163551581 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND4025 | FL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745280000000",
"number": "1275859878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9033",
"city": "STUART",
"state": "FL",
"postal_code": "349959033",
"telephone_number": "772-223-4916",
"fax_number": "772-223-2887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3496 NW FEDERAL HWY",
"address_2": "STE F",
"city": "JENSEN BEACH",
"state": "FL",
"postal_code": "349574441",
"telephone_number": "772-223-4916",
"fax_number": "772-223-2887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "ANDREA",
"middle_name": "L",
"credential": "RD LD/N",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-08",
"last_updated": "2025-04-22",
"certification_date": "2025-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND4025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jensen Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.