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MRS. BROOKE LEIGH FREDRICKSON LRD, CSG
NPI 1053645317
Dietitian, Registered in Cooperstown, ND

Active since September 18, 2009
1200 ROBERTS AVE NE, COOPERSTOWN, ND 58425(701) 797-2221 Get Directions Write a Review

NPPES record last updated: September 18, 2009. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mrs. Brooke Leigh Fredrickson Lrd, Csg NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. BROOKE LEIGH FREDRICKSON LRD, CSG (NPI 1053645317) is an individual dietitian, registered in Cooperstown, North Dakota, licensed in North Dakota (669) and active in the NPI registry since September 2009. She is a graduate of Other (2005).

NPPES Registry Identity

NPI1053645317
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameMRS. BROOKE LEIGH FREDRICKSONCredential: LRD, CSG
Location Address1200 ROBERTS AVE NECooperstown, ND 58425-7101
Mailing Address80 County Road 19Cooperstown, ND 58425-9168 · (701) 361-7154
Phone(701) 797-2221
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateSeptember 18, 2009
✔ NPI 1053645317 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in ND · 669
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
1200 ROBERTS AVE NE, Cooperstown, ND 58425
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Blue Cross Blue Shield of North Dakota, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Brooke Leigh Fredrickson Lrd, Csg is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3476905118
PECOS Enrollment IDI20240118002852

Medicare Billing Reassignments

2

Medicare enrollment records show Brooke Fredrickson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Carrington Health Center
47 mi
Critical Access
800 4TH ST N
Carrington, ND 58421
  • Reassigned Medicare billing, North Dakota enrollment
  • Also billed through NPI 1558389338 (North Dakota)
  • 15 clinicians in this Medicare group
NPI 1205807013 (701) 652-3141
Valley Christian Counseling Center Inc
73 mi
Professional
1112 NODAK DR S
Fargo, ND 58103
  • Reassigned Medicare billing, North Dakota enrollment
  • 22 clinicians in this Medicare group
NPI 1467559427 (701) 232-6224

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GRIGGS COUNTY NURSING HOME
Skilled Nursing Facility
1200 ROBERTS AVE NE
COOPERSTOWN, ND 58425
Griggs County (701) 797-2221
AGASSIZ DENTAL ASSOCIATES, PC
Dentist
1200 ROBERTS AVE NE
COOPERSTOWN, ND 58425
Griggs County (701) 797-2641
COOPERSTOWN MEDICAL CENTER
Skilled Nursing Facility
1200 ROBERTS AVE NE
COOPERSTOWN, ND 58425
Griggs County (701) 797-2221
DEBRA L. MIDDLETON FNP
Nurse Practitioner (Family)
1200 ROBERTS AVE NE
COOPERSTOWN, ND 58425
Griggs County (701) 797-2221
KEVIN S JACOBSON NP
Nurse Practitioner
1200 ROBERTS AVE NE, COOPERSTOWN MEDICAL CENTER
COOPERSTOWN, ND 58425
Griggs County (701) 797-2128
MR. NORMAN LEO BERTHIAUME FNP-C
Nurse Practitioner (Primary Care)
1200 ROBERTS AVE NE
COOPERSTOWN, ND 58425
Griggs County (701) 797-2221

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brooke Fredrickson's NPI number?

The NPI number for Brooke Fredrickson is 1053645317. It was assigned to this individual provider in the NPPES registry on September 18, 2009.

Where is Brooke Fredrickson located?

Brooke Fredrickson practices at 1200 Roberts Ave NE, Cooperstown, ND 58425. The listed phone number is (701) 797-2221.

What is Brooke Fredrickson's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Brooke Fredrickson enrolled in Medicare?

Yes. Brooke Fredrickson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Brooke Fredrickson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brooke Fredrickson reassigns Medicare benefits to 2 organizations: Carrington Health Center (Carrington, ND) and Valley Christian Counseling Center Inc (Fargo, ND). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Brooke Fredrickson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Brooke Fredrickson accept?

Health plans from Blue Cross Blue Shield of North Dakota, Blue Cross and Blue Shield of Texas and Sanford Health Plan list Brooke Fredrickson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Brooke Fredrickson was last updated on September 18, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.