Ryan Char Kelm

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD61557697 Issued in WA

Practice address

1831 N Lakewood Dr # 1
Coeur D Alene, ID 83814-2669

Phone

(208) 215-7199

NPI assigned

Apr 3, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, TX, IL, OK4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Dermatology

Education

University of Oklahoma College of Medicine, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• All Health Wound Care PLLC

  • Physical Medicine & Rehabilitation Physician
  • Coeur D Alene, ID
  • NPI 1255120929

  IL, OK, TX

  Medicare reassignment NPD Authorized official
• Chesnut MD

  • Dermatology Physician
  • Spokane, WA
  • NPI 1437798568
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1043772627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 N WHITMAN LN STE 200",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990196034",
            "telephone_number": "509-413-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1831 N LAKEWOOD DR # 1",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142669",
            "telephone_number": "208-215-7199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Staniford St # 250",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142517",
            "country_code": "US",
            "telephone_number": "617-724-6960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELM",
        "first_name": "RYAN",
        "middle_name": "CHAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD61557697",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "36.161422",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "125.074341",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raquel Angela Kellicut, MA
• Pamela Kellogg, MSPT
• Amanda Lynn Kelly, DPT
• Caleb Kelly, MD
• Tracey Dawn Kelly, PA-C
• Diana Lynn Kelsey, LCPC-5415
• Kathyrn Ann Sumner Kelso, LCPC
• Kimberlee K Kempt, DENTURIST
• Jeremy Kendall, LPC, QMHP, LAC
• Regina Marie Kendra

• Dermatology Physician in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Dermatology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.