MOUNTAIN PINE DERMATOLOGY, PLLC (NPI# 1659827665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659827665 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN PINE DERMATOLOGY, PLLC |
| Practice Address |
4664 N Penngrove Way Ste 100 Meridian ID 83646-7442 |
| Practice Telephone | 2088987467 |
| Mailing Telephone | 2088987467 |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2020-07-05 |
| Authorized Official Name | DR. RICHARD SCOTT THOMAS (OWNER) |
| Authorized Official Telephone | 2082507433 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | O-0934 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
4664 N PENNGROVE WAY STE 100 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83646-7442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265795660 | Richard Scott Thomas | Dermatology | 4664 N Penngrove Way Ste 100, Meridian, ID 83646-7442 | 2012-06-20 |
| 1043659196 | Chelsea Miller | Physician Assistant | 4664 N Penngrove Way Ste 100, Meridian, ID 83646-7442 | 2013-06-21 |
| 1710325758 | Benjamin Merrill Perry | Dermatology | 4664 N Penngrove Way Ste 100, Meridian, ID 83646-7442 | 2013-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982202743 | Jayson Paul Smith | Nurse Practitioner | 1545 East Leighfield Dr., Meridian, ID 83646 | 2020-10-14 |
| 1356977466 | Tanabell Health Services Inc | Assisted Living Facility | 2584 E Magic View Dr, Meridian, ID 83646 | 2020-03-20 |
| 1801351176 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 2656 E Magicview Dr, Meridian, ID 83646 | 2019-01-31 |
| 1306314323 | Cr Smiles - Meridian Dental Care LLC | Clinic/Center | 1500 W Cayuse Creek Dr, #100, Meridian, ID 83646 | 2018-11-07 |
| 1639644107 | Joseph Anomalay | Counselor | 6700 N. Linder Rd, Ste 156 #257, Meridian, ID 83646 | 2018-10-10 |
| 1275015950 | Mcmillan Family Dental Pllc | Clinic/Center | 1720 W. Mcmillan, Meridian, ID 83646 | 2018-08-30 |
| 1609327022 | Finding Home Healthcare, Inc. | Clinic/Center | 55 W Willowbrook Dr Ste 103, Meridian, ID 83646 | 2016-10-20 |
| 1952857161 | Mitchell Truong | Pharmacist | 622 E. Ustick Road, Caldwell, ID 83646 | 2016-08-28 |
| 1134511264 | Brittany Laub | Massage Therapist | 2572 N Stokesberry Pl #300, Meridian, ID 83646 | 2015-02-26 |
| 1194117366 | Westfall Ventures, Inc | Health Maintenance Organization | 2572 N. Stokesberry Pl, Meridian, ID 83646 | 2015-02-25 |
| Find all providers in zip 83646 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427460849 | Anna Allred Wile | Dermatology | 4331 Highway 39 N Ste A, Meridian, MS 39301-1007 | 2014-05-21 |
| 1265795660 | Richard Scott Thomas | Dermatology | 4664 N Penngrove Way Ste 100, Meridian, ID 83646-7442 | 2012-06-20 |
| 1295022861 | Kenneth Daniel Saul | Dermatology | 5002 Highway 39 N Bldg A, Meridian, MS 39301-1078 | 2011-07-05 |
| 1871798447 | Lawrence Benjamin Mceachin | Dermatology | 3827 Grandview Ave, Meridian, MS 39305 | 2007-06-15 |
| 1831229871 | Alisa Funke | Dermatology | 1618 Millennium Way, Suite 100, Meridian, ID 83642-6457 | 2007-03-07 |
| 1013054667 | Dermatology Center of Meridian Pa | Dermatology | 4612 29th Ave, Meridian, MS 39305-1652 | 2007-01-31 |
| 1972653566 | Naomi Beth Brooks | Dermatology | 3109 S Meridian Rd, Meridian, ID 83642-7088 | 2007-01-12 |
| 1285245423 | Dermatology & Skin Cancer Center Pllc | Dermatology | 4612 29th Ave, Meridian, MS 39305-1652 | 2020-08-12 |
| 1598374258 | Dermatology and Skin Cancer Center Pllc | Dermatology | 4612 29th Ave, Meridian, MS 39305-1652 | 2020-07-29 |
| 1417495615 | Boise Dermatology | Dermatology | 3109 S Meridian Rd, Meridian, ID 83642-7088 | 2017-02-07 |
| Find all providers in MERIDIAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.