1. Home
  2. Directory
  3. Idaho
  4. Boise
  5. Dermatology
  6. NPI Profile

DERMATOLOGY CLINIC OF IDAHO
NPI 1548758501
Dermatology in Boise, ID

Active since April 25, 2018CLIA 13D0521865 · Certificate of Compliance
7733 W EMERALD ST, BOISE, ID 83704(208) 939-4599(208) 939-5010 Get Directions Write a Review

NPPES record last updated: April 25, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dermatology Clinic Of Idaho NPPES

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

DERMATOLOGY CLINIC OF IDAHO (NPI 1548758501) is a healthcare organization registered as a dermatology in Boise, Idaho and active in the NPI registry since April 2018. The organization holds a CLIA Certificate of Compliance certificate valid through December 4, 2026 and lists Bret S Blackhart, Owner, as its authorized official.

NPPES Registry Identity

NPI1548758501
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameMOUNTAIN WEST DERM-BLACKHART, PLLC
Location Address7733 W EMERALD STBoise, ID 83704-9020
Mailing Address201 Franklin Rd Fl 3Brentwood, TN 37027-5214 · (615) 309-2636 · Fax (615) 309-2536
Phone(208) 939-4599
Fax(208) 939-5010
Organization SubpartYes
Authorized OfficialBret S BlackhartOwner · (775) 336-3624
Enumeration DateApril 25, 2018
✔ NPI 1548758501 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.
7733 W EMERALD ST, Boise, ID 83704
Open in Google Maps ↗

Other Names 1

Doing Business AsDermatology Clinic Of Idaho

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

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 13D0521865

Dermatology Clinic Of Idaho · Boise, ID
Active · expires Dec 4, 2026
CLIA Number13D0521865
Laboratory TypePhysician Office
Certificate Effective DateDecember 5, 2024
Certificate Expiration DateDecember 4, 2026
Laboratory DirectorKevin Kiene
Laboratory Phone(208) 376-4265
Laboratory LocationDermatology Clinic Of Idaho7733 W Emerald St, Boise, ID 83704
CLIA data matches this NPI record on: Address Name
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 3

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

MICHAEL J HOUSLEY PA-C
Physician Assistant
7733 W EMERALD ST
BOISE, ID 83704
Ada County (208) 376-3220
DR. JAMES H STEWART PHD, MD
Dermatology
7733 W EMERALD ST
BOISE, ID 83704
Ada County (208) 376-3220
DERMATOLOGY CLINIC OF IDAHO
Dermatology
7733 W EMERALD ST
BOISE, ID 83704
Ada County (208) 376-3220

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 Mountain West Derm-Blackhart, PLLC's NPI number?

The NPI number for Mountain West Derm-Blackhart, PLLC is 1548758501. It was assigned to this organization in the NPPES registry on April 25, 2018. The provider is doing business as Dermatology Clinic Of Idaho.

Where is Mountain West Derm-Blackhart, PLLC located?

Mountain West Derm-Blackhart, PLLC is located at 7733 W Emerald St, Boise, ID 83704. The listed phone number is (208) 939-4599.

What is Mountain West Derm-Blackhart, PLLC's specialty?

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

Does Mountain West Derm-Blackhart, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 13D0521865) is associated with this NPI, valid through December 4, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mountain West Derm-Blackhart, PLLC was last updated on April 25, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.