IDAHO COUNTY DERMATOLOGY, PLLC
NPI 1922835859
Nurse Practitioner in Grangeville, ID
About Idaho County Dermatology, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IDAHO COUNTY DERMATOLOGY, PLLC (NPI 1922835859) is a healthcare organization registered as a nurse practitioner in Grangeville, Idaho and active in the NPI registry since September 2024. The organization lists Jeanna Rendo, Owner/provider, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Idaho County Dermatology, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Idaho County Dermatology, PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 County Dermatology, PLLC's NPI number?
The NPI number for Idaho County Dermatology, PLLC is 1922835859. It was assigned to this organization in the NPPES registry on September 16, 2024.
Where is Idaho County Dermatology, PLLC located?
Idaho County Dermatology, PLLC is located at 113 S A St, Grangeville, ID 83530. The listed phone number is (208) 695-6668.
What is Idaho County Dermatology, PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Idaho County Dermatology, PLLC enrolled in Medicare?
Yes. Idaho County Dermatology, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Idaho County Dermatology, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Idaho County Dermatology, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Idaho County Dermatology, PLLC was last updated on February 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.
# Idaho County Dermatology, Pllc · NPI 1922835859
Nurse Practitioner organization in Grangeville, Idaho. Organization record, active in the CMS NPPES registry since September 16, 2024.
## Identity
- **NPI:** 1922835859 (Entity type: Organization)
- **Enumerated:** September 16, 2024
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **Organization subpart:** No
- **Authorized official:** Jeanna Rendo, OWNER/PROVIDER
## Practice location
- **Address:** 113 S A ST, Grangeville, ID 83530-1428
- **Phone:** (208) 695-6668
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 7, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1922835859) · Data from the CMS NPPES public registry.