IDAHO FALLS DERMATOLOGY P A
NPI 1487700464
Specialist in Idaho Falls, ID
About Idaho Falls Dermatology P A NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IDAHO FALLS DERMATOLOGY P A (NPI 1487700464) is a healthcare organization registered as a specialist in Idaho Falls, Idaho and active in the NPI registry since January 2007. The organization holds a CLIA Certificate of Compliance certificate valid through July 19, 2027 and lists Cornelius Paul Brooke, M.d., as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Group Practice 1
Accepted Insurance
CLIA Laboratory Certificates CMS CLIA
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 13D1063459
Idaho Falls Dermatology · Idaho Falls, IDOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
IDAHO FALLS, ID 83404
IDAHO FALLS, ID 83404
IDAHO FALLS, ID 83404
IDAHO FALLS, ID 83404
IDAHO FALLS, ID 83404
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 Idaho Falls Dermatology P A's NPI number?
The NPI number for Idaho Falls Dermatology P A is 1487700464. It was assigned to this organization in the NPPES registry on January 25, 2007.
Where is Idaho Falls Dermatology P A located?
Idaho Falls Dermatology P A is located at 2001 S Woodruff Ave Ste 12A, Idaho Falls, ID 83404. The listed phone number is (208) 522-8945.
What is Idaho Falls Dermatology P A's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Does Idaho Falls Dermatology P A hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 13D1063459) is associated with this NPI, valid through July 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Idaho Falls Dermatology P A accept?
Health plans from University of Utah Health Plans list Idaho Falls Dermatology P A 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 Idaho Falls Dermatology P A was last updated on July 5, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.
# Idaho Falls Dermatology P A · NPI 1487700464
Specialist organization in Idaho Falls, Idaho. Organization record, active in the CMS NPPES registry since January 25, 2007.
## Identity
- **NPI:** 1487700464 (Entity type: Organization)
- **Enumerated:** January 25, 2007
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** Cornelius Brooke, M.D.
## Practice location
- **Address:** 2001 S WOODRUFF AVE, STE 12A, Idaho Falls, ID 83404-6374
- **Phone:** (208) 522-8945
## Record status
- **NPPES last updated:** July 5, 2016
- **Other identifiers:** Other 77186 (ID); Medicare ID-Type Unspecified 1124989; Medicare UPIN E23470; and 1 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1487700464) · Data from the CMS NPPES public registry.