Mrs Brooke Leigh Fredrickson, LRD, CSG is a medicare enrolled "Dietitian, Registered" provider in Cooperstown, North Dakota. She graduated from medical school in 2005 and has 21 years of diverse experience with area of expertise as Registered Dietitian Or Nutrition Professional. She is a member of the group practice Valley Christian Counseling Center Inc and her current practice location is
1200 Roberts Ave Ne, Cooperstown, North Dakota. You can reach out to her office (for appointments etc.) via phone at
(701) 797-2221.
Mrs Brooke Leigh Fredrickson is licensed to practice in North Dakota (license number 669) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1053645317.
Healthcare Provider's Profile
| Full Name | Mrs Brooke Leigh Fredrickson |
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| Gender | Female |
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| Speciality | Registered Dietitian Or Nutrition Professional |
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| Experience | 21 Years |
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| Location | 1200 Roberts Ave Ne, Cooperstown, North Dakota |
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| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mrs Brooke Leigh Fredrickson graduated from medical school in 2005
NPI Data:
- NPI Number: 1053645317
- Provider Enumeration Date: 09/18/2009
- Last Update Date: 09/18/2009
Medicare PECOS Information:
- PECOS PAC ID: 3476905118
- Enrollment ID: I20240118002852
Medical Identifiers
Medical identifiers for Mrs Brooke Leigh Fredrickson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1053645317 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | 669 (North Dakota) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Valley Christian Counseling Center Inc | 6709845654 | 19 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Brooke Leigh Fredrickson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mrs Brooke Leigh Fredrickson, LRD, CSG
80 County Road 19,
Cooperstown, ND 58425-9168
Ph: (701) 361-7154 | Mrs Brooke Leigh Fredrickson, LRD, CSG
1200 Roberts Ave Ne,
Cooperstown, ND 58425-7101
Ph: (701) 797-2221 |
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