NPIMap

Organization Active NPI

High Valley Dermatology & Dermatologic Surgery PLLC

  • MOHS-Micrographic Surgery Physician
  • Idaho Falls, ID
National Provider Identifier
1891025334
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
M10198 Issued in ID
Legal business name
HIGH VALLEY DERMATOLOGY & DERMATOLOGIC SURGERY PLLC
Practice address
2085 Providence Way
Idaho Falls, ID 83404-4945
Phone
(208) 525-4888
Fax
(208) 525-4885
NPI assigned
Jan 6, 2010
Last updated
Apr 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Authorized official

Name
Lindsay Sewell, MDNPI 1346432226
Title
Doctor
Phone
(208) 525-4888

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
MOHS-Micrographic Surgery Physician 207ND0101X M10198 ID Primary

Addresses

Primary practice location

2085 Providence Way
Idaho Falls, ID 83404-4945

Mailing address

2085 Providence Way
Idaho Falls, ID 83404-4945
Phone (208) 525-4888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100125000598 ID Part B Supplier - Clinic/Group Practice 1850433137 Receives reassigned benefits from 11 practitioners
Practice locations: Idaho Falls, ID; Rigby, ID
O20200316002465 WY Part B Supplier - Clinic/Group Practice 1850433137 Receives reassigned benefits from 4 practitioners
Practice locations: Alpine, WY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776038400000",
    "number": "1891025334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 PROVIDENCE WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044945",
            "telephone_number": "208-525-4888",
            "fax_number": "208-525-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 PROVIDENCE WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044945",
            "telephone_number": "208-525-4888",
            "fax_number": "208-525-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGH VALLEY DERMATOLOGY & DERMATOLOGIC SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-06",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A",
        "authorized_official_last_name": "SEWELL",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "208-525-4888",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "ID",
            "license": "M10198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.