Active NPI
Hailey Lizabeth Collette, MS
- Pediatric Nutrition Registered Dietitian
- Boise, ID
National Provider Identifier
1003761636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nutrition Registered Dietitian
- Practice address
- 305 E Jefferson St
Boise, ID 83712-6231 - Phone
- (208) 381-7081
- Fax
- (208) 381-6009
- NPI assigned
- Feb 27, 2026
- 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 |
|---|---|---|---|---|
| Pediatric Nutrition Registered Dietitian | 133VN1004X | ID | Primary |
Addresses
Primary practice location
305 E Jefferson St
Boise, ID 83712-6231
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Other practice location 1
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 706-5437
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
190 E Bannock St
Boise, ID 83712-6241
PO Box
Boise, ID 83701
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Boise, ID
- NPI 1326336058
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1772150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774828800000",
"number": "1003761636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 E JEFFERSON ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126231",
"telephone_number": "208-381-7081",
"fax_number": "208-381-6009"
}
],
"practiceLocations": [
{
"address_1": "190 E Bannock St",
"address_purpose": "LOCATION",
"city": "Boise",
"state": "ID",
"postal_code": "837126241",
"country_code": "US",
"telephone_number": "208-706-5437",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLLETTE",
"first_name": "HAILEY",
"middle_name": "LIZABETH",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-02-27",
"last_updated": "2026-03-30",
"certification_date": "2026-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "ID",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.