DERMATOLOGY CLINIC OF IDAHO (NPI# 1811942188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811942188 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGY CLINIC OF IDAHO |
| Practice Address |
7733 W Emerald St Boise ID 83704-9020 |
| Practice Telephone | 2083763220 |
| Practice Fax Number | 2083227370 |
| Mailing Telephone | 2083763220 |
| Mailing Fax Number | 2083227370 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2013-06-27 |
| Authorized Official Name | DR. JAMES H STEWART (PRESIDENT) |
| Authorized Official Telephone | 2089394599 |
| Authorized Official Credential | PHD. M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Street Address |
7733 W EMERALD ST |
| City | BOISE |
| State | ID |
| Zip Code | 83704-9020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104870567 | James H Stewart | Dermatology | 7733 W Emerald St, Boise, ID 83704 | 2006-05-20 |
| 1548758501 | Mountain West Derm-blackhart, Pllc | Dermatology | 7733 W Emerald St, Boise, ID 83704-9020 | 2018-04-25 |
| 1790131480 | Tyler Jordan Mckinnon | Physician Assistant | 7733 W Emerald St, Boise, ID 83704-9020 | 2016-05-11 |
| 1043665789 | Michael J Housley | Physician Assistant | 7733 W Emerald St, Boise, ID 83704-9020 | 2016-05-02 |
| 1639567118 | Chelsea Wood Faust | Physician Assistant | 7733 W Emerald St, Boise, ID 83704-9020 | 2015-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| 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 |
|---|---|---|---|---|
| 1508345091 | Integrated Dermatology of Idaho LLC | Dermatology | 388 E Parkcenter Blvd, Boise, ID 83706-3942 | 2018-08-07 |
| 1104220797 | Boise Skin Clinic Pllc | Dermatology | 1636 S Hadley Ave, Boise, ID 83709-2684 | 2014-10-10 |
| 1487899365 | Jaclyn Golus Mentzer | Dermatology | 388 E. Parkcenter Blvd. Gem State Dermatology, Boise, ID 83706 | 2008-12-08 |
| 1982736435 | Joseph P. Fetzek M.d., P.a. | Dermatology | 10222 Summerwind Dr, Boise, ID 83704-3950 | 2007-03-11 |
| 1154475556 | Joseph Patrick Fetzek | Dermatology | 6111 W Overland Rd, Boise, ID 83709-3018 | 2007-01-22 |
| 1225107386 | Jhon R Hall | Dermatology | 13176 W Persimmon Lane, Boise, ID 83713 | 2006-11-06 |
| 1124106364 | Lindie K Borton | Dermatology | 3811 N Garden Center Way, Boise, ID 83703-5007 | 2006-11-02 |
| 1992808893 | Jared M Scott | Dermatology | 1906 S Vista Ave, Boise, ID 83705-3453 | 2006-09-06 |
| 1104870567 | James H Stewart | Dermatology | 7733 W Emerald St, Boise, ID 83704 | 2006-05-20 |
| 1548214265 | Steven M Mings | Dermatology | 388 E. Parkcenter Blvd., Boise, ID 83706 | 2006-05-19 |
| Find all providers in BOISE | ||||
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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.