Individual provider Active NPI

Lailina S Wisoff, RD

  • Registered Dietitian
  • Fort Collins, CO
National Provider Identifier
1457481293
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
230-LD Issued in HI
Practice address
6138 Spearmint CT
Fort Collins, CO 80528-7010
Phone
(303) 249-8061
Fax
(833) 806-0721
NPI assigned
Mar 7, 2007
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU
Registered Dietitian 133V00000X 011624-01 NY
Registered Dietitian 133V00000X 230-LD HI Primary

Addresses

Primary practice location

6138 Spearmint CT
Fort Collins, CO 80528-7010

Mailing address

6714 73Rd PL # 2
Middle Village, NY 11379-2527
Phone (303) 249-8061

Other practice location 1

41-464 Keehia Place
Paauilo, HI 96776-9677
Phone (303) 249-8061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011624-01NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1457481293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6714 73RD PL # 2",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792527",
            "telephone_number": "303-249-8061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6138 SPEARMINT CT",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805287010",
            "telephone_number": "303-249-8061",
            "fax_number": "833-806-0721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41-464 Keehia Place",
            "address_purpose": "LOCATION",
            "city": "Paauilo",
            "state": "HI",
            "postal_code": "967769677",
            "country_code": "US",
            "telephone_number": "303-249-8061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISOFF",
        "first_name": "LAILINA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "011624-01",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "HI",
            "license": "230-LD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.