Active NPI
John Stephen Collier, M.D.
- Pediatric Gastroenterology Physician
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- M-16895
- Practice address
- 305 E Jefferson St
Boise, ID 83712-6231 - Phone
- (208) 381-7310
- NPI assigned
- May 27, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 11018763A | IN | |
| Pediatric Gastroenterology Physician | 2080P0206X | 11262373-1205 | UT | |
| Pediatric Gastroenterology Physician | 2080P0206X | M-16895 | 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
705 Riley Hospital Dr
Room 5867
Indianapolis, IN 46202-5109
Phone (317) 948-7571
Other practice location 2
81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125
Phone (801) 213-3599
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11262373-1205 | UT | MD | Pediatric Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Pediatrics | Current | Accepting new patients |
| St Lukes Clinic-Treasure Valley LLC | Pediatrics | Current | Accepting new patients |
| St Lukes Regional Medical Center | Past | Accepting new patients | |
| University Pediatric Associates, Inc. | Pediatrics | Past | Accepting new patients |
Locations
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
305 E Jefferson St
Boise, ID 83712
Phone (208) 345-0715
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
Organizations & group practices 4
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.
-
dba St Lukes RHC - Trinity Mountain
- Family Medicine Physician
- Mountain Home, ID
- NPI 1417297821
Pediatrics
-
dba St Lukes Meridian Medical Center
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
-
- Pediatrics Physician
- Indianapolis, IN
- NPI 1457396541
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668643200000",
"number": "1659729903",
"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": "208-381-7310"
}
],
"practiceLocations": [
{
"address_1": "705 Riley Hospital Dr",
"address_2": "Room 5867",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462025109",
"country_code": "US",
"telephone_number": "317-948-7571",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "81 N Mario Capecchi Dr",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841131125",
"country_code": "US",
"telephone_number": "801-213-3599",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLLIER",
"first_name": "JOHN",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-27",
"last_updated": "2022-11-17",
"certification_date": "2022-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "11018763A",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "UT",
"license": "11262373-1205",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "ID",
"license": "M-16895",
"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 Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.