NPI age
7 years
Enumerated 2018-08-07
● Active Type 2 · Organization
Integrated Dermatology Of Idaho Llc
Integrated Dermatology Of Idaho Llc is 1 of 102 dermatology organizations in Idaho.
Primary specialty
Dermatology
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Queen
Owner
Last NPPES update
2018-08-07
Source: monthly bulk 2026-05
How this organization compares
Across 102 active dermatology providers in Idaho.
NPI age
7 years
↓ 11 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2018 → 2026
2018-08Enumerated in NPPES
2018
2026
Where they practice
Primary practice location
388 E Parkcenter Blvd
Boise, ID 837063942
Mailing address
4700 Exchange Ct Ste 110
Boca Raton, FL 334314450
Authorized official
Jeffrey Queen
Owner
📞 5613142000
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Katherine Ledford, PA Physician Assistant NPI 1386233997
Specialties
-
Dermatology PrimaryA 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...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
GEM State Dermatology
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.