ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTD (NPI# 1164469870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164469870 |
| Entity Type | Organization |
| Organization Name | ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTD |
| Other Organization Name | ST LUKE'S CANYON VIEW BEHAVIORAL HEALTH SERVICES |
| Practice Address |
228 Shoup Ave W Twin Falls ID 83301-5022 |
| Mailing Address |
Po Box 2777 Boise ID 83701-2777 |
| Practice Telephone | 2087346760 |
| Mailing Telephone | 2087065000 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2020-02-20 |
| Authorized Official Name | JEFF TAYLOR (CFO, SR VP FINANCE) |
| Authorized Official Telephone | 2083812520 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE SHIELD 1500 PROV NUM | 000010006672 | 01 |
| ID | BLUE SHIELD HOSP PROV # | 000010006673 | 01 |
| ID | RAILROAD 1500 PROV NUMBER | CE0659 | 01 |
| ID | BLUE CROSS 1500 PROV NUMB | 8C535 | 01 |
| ID | BLUE CROSS HOSP PROV # | 03269 | 01 |
| ID | NEVADA MEDICAID INPT PROV | 100505262 | 01 |
| Other Name | Type Code |
|---|---|
| ST LUKE'S CANYON VIEW BEHAVIORAL HEALTH SERVICES | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285833343 | St Lukes Magic Valley Regional Medical Center Ltd | Rehabilitation Unit | 775 Pole Line Road West, Suite 307, Twin Falls, ID 83301 | 2007-07-17 |
| 1881224327 | St Lukes Magic Valley Regional Medical Center Ltd | Pharmacy | 801 Pole Line Rd W, Twin Falls, ID 83301-5810 | 2020-01-23 |
| 1730511254 | St Lukes Magic Valley Regional Medical Center Ltd | Medicare Defined Swing Bed Unit | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2013-08-07 |
| 1043257736 | St Lukes Magic Valley Regional Medical Center Ltd | Hospice Care, Community Based | 601 Pole Line Rd, Twin Falls, ID 83301-4085 | 2006-06-01 |
| Street Address |
228 SHOUP AVE W |
| City | TWIN FALLS |
| State | ID |
| Zip Code | 83301-5022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780150979 | Michelle Harcourt | Registered Nurse | 228 Shoup Ave W, Twin Falls, ID 83301-5022 | 2018-10-16 |
| 1528441631 | Lisa Catherine Reeves | Social Worker | 228 Shoup Ave W, Twin Falls, ID 83301-5022 | 2015-07-07 |
| 1417330119 | St. Luke's Canyon View | Psychiatric Unit | 228 Shoup Ave W, Twin Falls, ID 83301-5022 | 2015-06-30 |
| 1154723120 | Jeremiah W Neibling | Nurse Practitioner | 228 Shoup Ave W, Twin Falls, ID 83301-5022 | 2014-09-22 |
| 1841535267 | Mildred Azucena Gaitan-gonzalez | Social Worker | 228 Shoup Ave W, Twin Falls, ID 83301-5022 | 2012-12-11 |
| 1881967511 | Ronda Elizabeth Case | Social Worker | 228 Shoup Ave W, Twin Falls, ID 83301-5022 | 2012-02-10 |
| 1053628339 | Pat M Kaes | Counselor | 228 Shoup Ave W, Twin Falls, ID 83301-5022 | 2010-09-08 |
| 1043527302 | Jeremy Royal | Counselor | 228 Shoup Ave W, Twin Falls, ID 83301-5022 | 2010-09-08 |
| 1548572274 | Umesh Bhandari | Psychiatry & Neurology | 228 Shoup Ave W, Twin Falls, ID 83301 | 2010-07-10 |
| 1326161480 | Lisa C Mccue Pugrud | Counselor | 228 Shoup Ave W, Twin Falls, ID 83301-5022 | 2007-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
| 1780146316 | Frontier Pediatric Partners, Pllc | Pediatrics | 1502 Locust Street N #700, Twin Falls, ID 83301 | 2019-04-02 |
| 1972073377 | Wood River Acupuncture | Acupuncturist | 1625 Addison Ave East, Twin Falls, ID 83301 | 2018-11-28 |
| 1235629874 | Lonnie Paul | Counselor | 1092 Eastland Dr N Ste A, Twin Falls, ID 83301 | 2018-05-17 |
| 1679060966 | Christina Jirapha Thongdee | Social Worker | 625 Poleline Road West, Suite 2a, Twin Falls, ID 83301 | 2018-04-23 |
| 1437658499 | Tyrel Kevin Ward | Chiropractor | 2167 Village Park Ave., Suite 100, Twin Falls, ID 83301 | 2018-02-06 |
| 1851836381 | Tanabell Health Services, Inc | Skilled Nursing Facility | 1134 Cheney Drive West, Twin Falls, ID 83301 | 2016-12-19 |
| 1578005195 | Matthew Carter | Physical Therapist | 1053 Eastland Drive, Twin Falls, ID 83301 | 2016-11-14 |
| 1790227783 | Murvat Usmanova | Nurse Practitioner | 775 Pole Line Road W, Suite 203, Twin Falls, ID 83301 | 2016-11-08 |
| 1265894687 | Shawna Fultz | Social Worker | 1201 Fall Ave East Suite C, Twin Falls, ID 83301 | 2016-03-24 |
| Find all providers in zip 83301 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417330119 | St. Luke's Canyon View | Psychiatric Unit | 228 Shoup Ave W, Twin Falls, ID 83301-5022 | 2015-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740287911 | Eastern Idaho Health Services Inc | Psychiatric Unit | 2280 E 25th St, Idaho Falls, ID 83404-7542 | 2005-07-04 |
| 1841719713 | Bmh Inc | Psychiatric Unit | 98 Poplar St, Blackfoot, ID 83221 | 2017-09-12 |
| 1205975851 | St. Joseph Hospital, LLC | Psychiatric Unit | 415 6th St, Lewiston, ID 83501-2431 | 2007-02-06 |
| 1568567360 | Kootenai Health | Psychiatric Unit | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2006-09-14 |
| 1770687857 | St. Alphonsus Reg Med | Psychiatric Unit | 1055 N Curtis Rd, Boise, ID 83706 | 2006-09-11 |
| 1295777274 | Portneuf Medical Center Behavioral Health Servi | Psychiatric Unit | 777 Hospital Way, Pocatello, ID 83201-5175 | 2006-06-12 |
| 1891732905 | West Valley Medical Center, Inc. | Psychiatric Unit | 1717 Arlington Ave, Caldwell, ID 83605-4802 | 2006-05-31 |
| City | TWIN FALLS |
| Zip Code | 83301 |
Please comment or provide details below to improve the information on ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.