Idaho Skin Institute LLC
NPI 1184375867ActiveOrganization· Dermatology· Chubbuck, ID
Dermatology in Chubbuck, Idaho, registered in NPPES in January 2022. The authorized official on file is Earl Stoddard, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1184375867 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 13, 2022 |
| Last updated in NPPES | Feb 4, 2025 |
| Certified by provider | Feb 4, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (ID) |
|---|
Other Dermatology providers in Chubbuck
- 1972745594
- 1558756106