NPI age
14 years
Enumerated 2012-02-11
● Active Type 2 · Organization
Keller Skin & Cancer Care Pc
Keller Skin & Cancer Care Pc is 1 of 102 dermatology organizations in Idaho.
Primary specialty
Dermatology
Plus 2 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Keller
President
Last NPPES update
2022-11-03
Source: monthly bulk 2026-05
How this organization compares
Across 102 active dermatology providers in Idaho.
NPI age
14 years
↓ 4 yr below median
Practice locations
1
0 secondary on file
Subspecialties
2
In the 37% of peers with subspecialties
NPI lifetime · 2012 → 2026
2012-02Enumerated in NPPES
2012
2026
Where they practice
Primary practice location
1605 E Riverside Drive
Eagle, ID 83616
Mailing address
1605 E Riverside Dr
Eagle, ID 836166237
Authorized official
Wade Robert Keller, DO
President
📞 2089396227
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Angela Coyne, PA Physician Assistant NPI 1538276928
- Heather Knutson, N.P. Dermatology NPI 1215936034
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...
-
DermatologyThe highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased...
-
DermatologyProcedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery,...
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Keller Skin Care
-
Keller Skin Care
Practice context
Multi-provider organization. 2 individual providers 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.