NPIMap

Organization Active NPI

Stoddard & Bingham Medical of Twin Falls PLLC

Doing business as Idaho Skin Institute of Twin Falls

  • Dermatology Physician
  • Twin Falls, ID
National Provider Identifier
1114691813
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
STODDARD & BINGHAM MEDICAL OF TWIN FALLS PLLC
Doing business as
Idaho Skin Institute of Twin Falls
Practice address
1411 Falls Ave E Ste 1002
Twin Falls, ID 83301-3459
Phone
(208) 595-5424
Fax
(208) 595-5426
NPI assigned
Aug 5, 2021
Last updated
Jul 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Authorized official

Name
Earl R Stoddard, MDNPI 1760400238
Title
Owner
Phone
(208) 238-7546

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

1411 Falls Ave E Ste 1002
Twin Falls, ID 83301-3459

Mailing address

147 W Chubbuck Rd
Chubbuck, ID 83202-2314
Phone (208) 238-7546

Other identifiers 4

IdentifierTypeStateIssuer
1164834073OtherPERSONAL NPI
1548482482OtherPERSONAL NPI
1760400238OtherIDPERSONAL NPI
1528533296OtherIDPERSONAL NPI

Other names 1

  • Idaho Skin Institute of Twin Falls Doing business as

National Provider Directory

National Provider Directory

Locations

1411 Falls Ave E
Ste 1002
Twin Falls, ID 83301
Phone (208) 595-5424

1445 Fillmore St
Twin Falls, ID 83301

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1114691813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 W CHUBBUCK RD",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022314",
            "telephone_number": "208-238-7546",
            "fax_number": "208-237-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 FALLS AVE E STE 1002",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013459",
            "telephone_number": "208-595-5424",
            "fax_number": "208-595-5426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STODDARD & BINGHAM MEDICAL OF TWIN FALLS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-05",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "STODDARD",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-238-7546",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1164834073",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1548482482",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1760400238",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1528533296",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Idaho Skin Institute of Twin Falls",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Idaho Skin Institute of Twin Falls",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.