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DERMATOLOGY & LASER CENTER OF CANYON COUNTY
NPI 1578694238
Dermatology in Nampa, ID

Active since March 07, 2007CLIA 13D1025651 · Certificate of Compliance
318 2ND ST S, NAMPA, ID 83651(208) 467-3006(208) 467-1155 Get Directions Write a Review

NPPES record last updated: October 15, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dermatology & Laser Center Of Canyon County NPPES

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

DERMATOLOGY & LASER CENTER OF CANYON COUNTY (NPI 1578694238) is a healthcare organization registered as a dermatology in Nampa, Idaho and active in the NPI registry since March 2007. The organization holds a CLIA Certificate of Compliance certificate valid through November 7, 2026 and lists Gavin R Powell, President, as its authorized official.

NPPES Registry Identity

NPI1578694238
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameDERMATOLOGY CENTER OF CANYON COUNTY
Location Address318 2ND ST SNampa, ID 83651-3765
Mailing Address318 2nd St SNampa, ID 83651-3765 · (208) 467-3006 · Fax (208) 467-1155
Phone(208) 467-3006
Fax(208) 467-1155
Organization SubpartNo
Authorized OfficialGavin R PowellPresident · (208) 467-3006
Enumeration DateMarch 7, 2007
Last NPPES UpdateOctober 15, 2007
✔ NPI 1578694238 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in ID · M7519
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.
318 2ND ST S, Nampa, ID 83651
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Other Names 1

Other NameDermatology & Laser Center Of Canyon County

Other Identifiers 1

Medicare ID-Type Unspecified1376908ID

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..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 13D1025651

Dermatology Center Of Canyon County · Nampa, ID
Active · expires Nov 7, 2026
CLIA Number13D1025651
Laboratory TypePhysician Office
Certificate Effective DateNovember 8, 2024
Certificate Expiration DateNovember 7, 2026
Laboratory DirectorTed J. Ryser
Laboratory Phone(208) 467-3006
Laboratory LocationDermatology Center Of Canyon County318 2nd St S, Nampa, ID 83651
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 5

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

DR. GAVIN ROSS POWELL MD
Dermatology
318 2ND ST S
NAMPA, ID 83651
Canyon County (208) 467-3006
ANDREA CORTES DOBSON PA
Physician Assistant
318 2ND ST S
NAMPA, ID 83651
Canyon County (208) 467-3006
AMANDA VANDER WOUDE
Physician Assistant
318 2ND ST S
NAMPA, ID 83651
Canyon County (208) 467-3006
MR. SETH ALAN PERMANN PA-C
Physician Assistant
318 2ND ST S
NAMPA, ID 83651
Canyon County (208) 467-3006
THEA HEATON PA-C
Physician Assistant
318 2ND ST S
NAMPA, ID 83651
Canyon County (208) 467-3006

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 Dermatology Center Of Canyon County's NPI number?

The NPI number for Dermatology Center Of Canyon County is 1578694238. It was assigned to this organization in the NPPES registry on March 7, 2007. The provider is also known as Dermatology & Laser Center Of Canyon County.

Where is Dermatology Center Of Canyon County located?

Dermatology Center Of Canyon County is located at 318 2nd St S, Nampa, ID 83651. The listed phone number is (208) 467-3006.

What is Dermatology Center Of Canyon County's specialty?

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

Does Dermatology Center Of Canyon County hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 13D1025651) is associated with this NPI, valid through November 7, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Dermatology Center Of Canyon County accept?

Health plans from Moda Health Plan, Inc. list Dermatology Center Of Canyon County 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 Dermatology Center Of Canyon County was last updated on October 15, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.