Ada West Dermatopathology, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

P1629 Issued in ID

Legal business name

ADA WEST DERMATOPATHOLOGY, LLC

Practice address

1618 Millenium Way
Ste 220
Meridian, ID 83642-6439

Phone

(208) 884-3376

Fax

(208) 884-0858

NPI assigned

Aug 28, 2012

Last updated

May 18, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

ADA WEST DERMATOLOGY, PCAs reported in NPPES

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

Authorized official

Name

Colleen Jones

Title

Cfo

Phone

(208) 884-3376

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Part of

Ada West Dermatology PC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Ada West Dermatology, PC

  • Dermatology Physician
  • Meridian, ID
  • NPI 1518973338

  Member Of

  NPD member

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Ada West Dermatology, PC

  • Dermatology Physician
  • Meridian, ID
  • NPI 1518973338
  NPPES parent name

Practitioners 5

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.

• Elizabeth Keiser, MD, MPH

  • Dermatopathology (Pathology) Physician
  • Meridian, ID
  • NPI 1942696711
  NPD
• Cameron Wales

  • Dermatopathology (Pathology) Physician
  • Cape Coral, FL
  • NPI 1538696455
  NPD
• Stephen J Frelly, PA

  • Medical Physician Assistant
  • Meridian, ID
  • NPI 1114966959
  NPD (past)
• Alan J.a. Pitt, MD

  • Dermatology Physician
  • Meridian, ID
  • NPI 1659301950
  NPD (past)
• Jennifer L Scott, MD, PHD

  • Dermatopathology Physician
  • Meridian, ID
  • NPI 1528590056
  NPD (past)

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779062400000",
    "number": "1760730436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 MILLENIUM WAY",
            "address_2": "STE 220",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426439",
            "telephone_number": "208-884-3376",
            "fax_number": "208-884-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 MILLENIUM WAY",
            "address_2": "STE 220",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426439",
            "telephone_number": "208-884-3376",
            "fax_number": "208-884-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADA WEST DERMATOPATHOLOGY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADA WEST DERMATOLOGY, PC",
        "enumeration_date": "2012-08-28",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "208-884-3376"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "ID",
            "license": "P1629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "20002043",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ada Chiropractic LLC
• Ada West Counseling LLC
• Ada West Dermatology, PC
• Ada/Canyon Visiting Angels, LLC
• Adacare Dental & Dentures PLLC
• Adams Center for Counseling LLC
• Brenda J Adams, MD
• Candice Elaine Adams, DNP, APRN, AGPCNP-BC

• Clinical Medical Laboratory in Meridian, ID
• Providers in Meridian, ID by specialty
• Clinical Medical Laboratory in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.