BOISE DERMATOLOGY (NPI# 1417495615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417495615 |
| Entity Type | Organization |
| Organization Name | BOISE DERMATOLOGY |
| Practice Address |
3109 S Meridian Rd Meridian ID 83642-7088 |
| Practice Telephone | 2027160051 |
| Mailing Telephone | 2027160051 |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2017-02-07 |
| Authorized Official Name | NAOMI BETH BROOKS (DERMATOLGIST) |
| Authorized Official Telephone | 2027160051 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | M-11311 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
3109 S MERIDIAN RD |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-7088 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972653566 | Naomi Beth Brooks | Dermatology | 3109 S Meridian Rd, Meridian, ID 83642-7088 | 2007-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| 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 |
| 1659827665 | Mountain Pine Dermatology, Pllc | Dermatology | 4664 N Penngrove Way Ste 100, Meridian, ID 83646-7442 | 2016-08-30 |
| 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.