Gavin Ross Powell, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

M7519 Issued in ID

Practice address

318 2ND St S
Nampa, ID 83651-3765

Phone

(208) 467-3006

Fax

(208) 467-1155

NPI assigned

Jun 27, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

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 1

Specialty

Dermatology

Education

University of Texas Southwestern Medical School at Dallas, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Center of Canyon CountyGroup PAC ID 3072589209, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013

Merit-based Incentive Payment System (MIPS)

Final score

97.12 of 100Reported as group

Quality

94.24

Improvement activities

40

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.

• Dermatology Center of Canyon County

  • Dermatology Physician
  • Nampa, ID
  • NPI 1578694238
  Medicare reassignment Care Compare group NPD Authorized official
• Stephen William Doggett, M.D. PA

  • Radiation Oncology Physician
  • Newport Beach, CA
  • NPI 1427281666
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Alphonsus Medical Center Nampa, Inc.

  • General Acute Care Hospital
  • Nampa, ID
  • NPI 1659371870
  Care Compare affiliation

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1215933940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 2ND ST S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513765",
            "telephone_number": "208-467-3006",
            "fax_number": "208-467-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 2ND ST S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513765",
            "telephone_number": "208-467-3006",
            "fax_number": "208-467-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "GAVIN",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ID",
            "license": "M7519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805173400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Possibilities Coaching, Counseling and Retreats
• Jennifer Lynn Potts
• Lisa Potts
• Corie Christine Pounders
• Alyse Sarah Powell, BSM, CPM, LM
• Heather Powell, FNP-C
• Tyler Powell, DPT
• Ginger Lee Powers, MSN, RN, FNP-BC
• Robert Alan Pratt, D.M.D.
• Samantha Prazak

• Dermatology Physician in Nampa, ID
• Providers in Nampa, ID by specialty
• Dermatology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.