MRS. BROOKE LEIGH FREDRICKSON (NPI# 1053645317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053645317 |
| Entity Type | Individual |
| Full Name | MRS. BROOKE LEIGH FREDRICKSON |
| Credential | LRD, CSG |
| Practice Address |
1200 Roberts Ave Ne Cooperstown ND 58425-7101 |
| Mailing Address |
80 County Road 19 Cooperstown ND 58425-9168 |
| Practice Telephone | 7017972221 |
| Mailing Telephone | 7013617154 |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2009-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 669 | ND | Dietary & Nutritional Service Providers |
| Street Address |
1200 ROBERTS AVE NE |
| City | COOPERSTOWN |
| State | ND |
| Zip Code | 58425-7101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851393144 | Brian Twete | Nurse Practitioner | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2005-06-01 |
| 1144500596 | Griggs County Nursing Home | Skilled Nursing Facility | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2011-08-17 |
| 1134304231 | Cooperstown Medical Center | Durable Medical Equipment & Medical Supplies | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2008-01-08 |
| 1962548214 | Cooperstown Medical Center | Clinic/Center | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2007-01-30 |
| 1376635151 | Cooperstown Medical Center | Medicare Defined Swing Bed Unit | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-09-29 |
| 1285726067 | Cooperstown Medical Center | Skilled Nursing Facility | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-09-29 |
| 1184716045 | Agassiz Dental Associates, PC | Dentist | 1200 Roberts Ave Ne, Cooperstown, ND 58425 | 2006-09-29 |
| 1235239229 | Cooperstown Medical Center | General Acute Care Hospital | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-09-22 |
| 1770691651 | Norman Leo Berthiaume | Nurse Practitioner | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-08-29 |
| 1548378474 | Cooperstown Medical Center | General Acute Care Hospital | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-08-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932310315 | Outlook Chiropractic | Chiropractor | 605 8th St Nw, Cooperstown, ND 58425 | 2007-05-25 |
| 1972923373 | Cia Gronneberg | Social Worker | 912 Burrel Ave Se, Box 567, Cooperstown, ND 58425-0567 | 2014-04-24 |
| 1235559683 | Griggs County | Public Health or Welfare | 912 Burrel Ave Se, Cooperstown, ND 58425-0567 | 2014-04-24 |
| 1912099870 | Arlo D Neumiller | Dentist | 1200 Roberts Av Ne, Cooperstown, ND 58425-0569 | 2006-09-29 |
| 1821210154 | Leon Donald Paczkowski | Pharmacist | 848 Burrell Ave., Cooperstown, ND 58425-0627 | 2007-05-03 |
| 1558379248 | Pharmacists Associates LLC | Pharmacy | 901 Burrell Ave Se, Cooperstown, ND 58425-0627 | 2006-08-04 |
| 1982814497 | City of Cooperstown | Ambulance | 611 9th St. Ne, Cooperstown, ND 58425-0712 | 2007-05-23 |
| 1396258745 | Rachel Marie Dahl | Pharmacist | 901 Burrel Ave Sw, Cooperstown, ND 58425-0901 | 2017-11-08 |
| 1710473764 | Larissa Ann Haug | Physician Assistant | 1200 Roberts Avenue Ne, Cooperstown, ND 58425-7101 | 2018-07-02 |
| 1992051221 | Essential Chiropractic Pllc | Chiropractor | 402 4th St Sw, Cooperstown, ND 58425-7541 | 2012-07-24 |
| Find all providers in zip 58425 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427599307 | Rachel Schappert | Dietitian, Registered | 1 Atwell Rd, Cooperstown, NY 13326 | 2017-03-13 |
| 1750824041 | Stacia Southcott | Dietitian, Registered | 1 Atwell Rd, Cooperstown, NY 13326-1301 | 2016-11-18 |
| 1538525209 | Rhianna Wagner | Dietitian, Registered | 1 Atwell Rd, Cooperstown, NY 13326-1301 | 2016-01-11 |
| 1285090332 | Monica Tomazic | Dietitian, Registered | 1 Atwell Rd, Cooperstown, NY 13326-1301 | 2016-01-05 |
| 1184094971 | Deborah Lee Faoro-rodrigues | Dietitian, Registered | 1 Atwell Rd, Cooperstown, NY 13326-1301 | 2015-10-06 |
| 1982960910 | Jonathan Belknap | Dietitian, Registered | 1 Atwell Rd, Cooperstown, NY 13326-1301 | 2012-04-04 |
| 1780903658 | Heather Barreto | Dietitian, Registered | 1 Atwell Rd, Cooperstown, NY 13326-1301 | 2010-05-18 |
| 1356584122 | Dawn Abounader Chase | Dietitian, Registered | 1 Atwell Rd, Cooperstown, NY 13326-1301 | 2009-04-09 |
| 1083884605 | Holly A Hobbie-begeal | Dietitian, Registered | 1 Atwell Rd, Cooperstown, NY 13326-1301 | 2008-03-11 |
| 1770615999 | Mary Ann Davis | Dietitian, Registered | 1 Atwell Rd, Cooperstown, NY 13326-1301 | 2007-03-12 |
| Find all providers in COOPERSTOWN | ||||
| City | COOPERSTOWN |
| Zip Code | 58425 |
Please comment or provide details below to improve the information on MRS. BROOKE LEIGH FREDRICKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.