KELLER SKIN CARE – NPI #1649543323
Dermatology

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.

Health Care Provider Taxonomy Code for Dermatology

KELLER SKIN CARE is a dermatologist located in EAGLE, ID. NPPES has assigned the NPI number 1649543323 to KELLER SKIN CARE on February 11, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “KELLER SKIN CARE” is a dba name, the actual legal business name for this organization is KELLER SKIN & CANCER CARE PC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207N00000X from the Health Care Provider Taxonomy code set, which is classified as Dermatology.

The NPI profile was previously updated about 4 years ago on Nov 03, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for KELLER SKIN CARE below.

NPI Profile for
KELLER SKIN & CANCER CARE PC

NPI Number
1649543323
Enumeration Date

(more than 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
KELLER SKIN & CANCER CARE PC
Doing Business As (dba): KELLER SKIN CARE
Primary location
1605 E RIVERSIDE DRIVE
EAGLE, ID 83616
Phone: (208) 939-6227 Fax: (208) 939-6442
Mailing address
1605 E RIVERSIDE DR
EAGLE, ID 83616-6237
Phone: (208) 939-6227 Fax: (208) 939-6442
Organization Subpart
No
Authorized Official
WADE KELLER
PRESIDENT
Phone: (208) 939-6227
Updated
Certification Date
Nov 03, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207N00000X
- Dermatology (Primary)		 ID O-0559
207NS0135X
- Dermatology / Procedural Dermatology
207ND0101X
- Dermatology / MOHS-Micrographic Surgery

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
DIRECT MAIL ADDRESS
Content Type
OTHER
Affiliation
N
Endpoint Location
1605 E RIVERSIDE DRIVE,
EAGLE, ID 77025-1669