Individual provider Active NPI

Trevor Coke II

  • Registered Dietitian
  • Miramar, FL
National Provider Identifier
1396439659
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND12019 Issued in FL
Practice address
2452 Centergate Dr Apt 103
Miramar, FL 33025-7211
Phone
(954) 892-7711
NPI assigned
Jun 7, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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 ND12019 FL Primary

Addresses

Primary practice location

2452 Centergate Dr Apt 103
Miramar, FL 33025-7211

Mailing address

2452 Centergate Dr Apt 103
Miramar, FL 33025-7211
Phone (954) 892-7711

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ND12019FLMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1396439659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2452 CENTERGATE DR APT 103",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330257211",
            "telephone_number": "954-892-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2452 CENTERGATE DR APT 103",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330257211",
            "telephone_number": "954-892-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COKE",
        "first_name": "TREVOR",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND12019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.