Colleen Anne Dibble, MS, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

D-464 Issued in ID

Practice address

400 W Fort St
Boise, ID 83702-4531

Phone

(208) 422-1000

NPI assigned

Jan 21, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1306436571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 N 16TH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837023431",
            "telephone_number": "208-319-4330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W FORT ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024531",
            "telephone_number": "208-422-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBBLE",
        "first_name": "COLLEEN",
        "middle_name": "ANNE",
        "credential": "MS, RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ID",
            "license": "D-464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "colleen.dibble@va.gov",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "400 W Fort St",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837024531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Camille Dialogue, PTA
• Diane Barnhill Suntiger Enterprises
• Jeannee Diaz, RD
• Jennifer Diaz, PHARMD
• Savannah Diaz, OTR/L
• Emme Lee Dibble
• Pamela Dae Dick, MS, RD, CDCES
• Michael Dean Dickens, R.PH.
• Gregory Dickerson, LCSW
• Kimberly A Dickey, OT

• Registered Dietitian in Boise, ID
• Providers in Boise, ID by specialty
• Registered Dietitian in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.