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WRAY DERMATOLOGY
NPI 1457110298
Dermatology in Blackfoot, ID

Active since March 14, 2024CLIA Certified · 2 labs
1355 PARKWAY DR STE A, BLACKFOOT, ID 83221(986) 275-0003(986) 275-0005 Get Directions Write a Review

NPPES record last updated: May 6, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 6, 2026, Jun 27, 2025, Jul 26, 2024 (3 updates tracked since 2024).

About Wray Dermatology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WRAY DERMATOLOGY (NPI 1457110298) is a healthcare organization registered as a dermatology in Blackfoot, Idaho and active in the NPI registry since March 2024. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Pocatello, and lists Adam Wray, Owner, as its authorized official.

NPPES Registry Identity

NPI1457110298
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameWRAY DERMATOLOGY
Location Address1355 PARKWAY DR STE ABlackfoot, ID 83221-1656
Mailing Address1355 Parkway Dr Ste ABlackfoot, ID 83221-1656 · (986) 275-0003 · Fax (986) 275-0005
Phone(986) 275-0003
Fax(986) 275-0005
Organization SubpartNo
Authorized OfficialAdam WrayOwner · (986) 275-0003
Enumeration DateMarch 14, 2024
Last NPPES UpdateMay 6, 20263 updates tracked since enumeration
NPPES CertifiedMay 6, 2026
✔ NPI 1457110298 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
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.
1355 PARKWAY DR STE A, Blackfoot, ID 83221
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Secondary Practice Location 1

Location 1500 S 11th Ave Ste 301Pocatello, ID 83201-4879 · Phone (986) 228-8765 · Fax (986) 275-0005

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., University of Utah Health Plans.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 13D0938872

Wray Dermatology · Blackfoot, ID
Active · expires Jul 10, 2027
CLIA Number13D0938872
Laboratory TypePhysician Office
Certificate Effective DateJuly 11, 2025
Certificate Expiration DateJuly 10, 2027
Laboratory DirectorAdam D. Wray
Laboratory Phone(986) 275-0003
Laboratory LocationWray Dermatology1355 Parkway Drive, Blackfoot, ID 83221
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 13D2306016

Wray Dermatology · Pocatello, ID
Active · expires Jun 4, 2027
CLIA Number13D2306016
Laboratory TypePhysician Office
Certificate Effective DateJune 5, 2025
Certificate Expiration DateJune 4, 2027
Laboratory DirectorAdam D. Wray
Laboratory Phone(986) 228-8765
Laboratory LocationWray Dermatology500 S 11th Ave Ste 301, Pocatello, ID 83201
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TANNER D MITTON PA-C
Physician Assistant
1355 PARKWAY DR STE A
BLACKFOOT, ID 83221
Bingham County (986) 275-0003
DR. ADAM WRAY DO
Dermatology
1355 PARKWAY DR STE A
BLACKFOOT, ID 83221
Bingham County (986) 275-0003

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wray Dermatology's NPI number?

The NPI number for Wray Dermatology is 1457110298. It was assigned to this organization in the NPPES registry on March 14, 2024.

Where is Wray Dermatology located?

Wray Dermatology is located at 1355 Parkway Dr Ste A, Blackfoot, ID 83221. The listed phone number is (986) 275-0003.

What is Wray Dermatology's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Wray Dermatology hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Wray Dermatology accept?

Health plans from Moda Health Plan, Inc. and University of Utah Health Plans list Wray Dermatology as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wray Dermatology was last updated on May 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.