ST LUKES REGIONAL MEDICAL CENTER (NPI# 1316980345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316980345 |
| Entity Type | Organization |
| Organization Name | ST LUKES REGIONAL MEDICAL CENTER |
| Other Organization Name | ST LUKES INTERNAL MEDICINE |
| Practice Address |
520 S Eagle Rd Suite 3102 Meridian ID 83642-6351 |
| Mailing Address |
Po Box 550 Boise ID 83701-0550 |
| Practice Telephone | 2087065100 |
| Practice Fax Number | 2087065169 |
| Mailing Telephone | 2087065100 |
| Mailing Fax Number | 2087065169 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CARRIE LYNNE COWGILL (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 2083814137 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| ST LUKES INTERNAL MEDICINE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639356173 | St Lukes Regional Medical Center | Family Medicine | 11311 W Chinden Blvd, Boise, ID 83714-1021 | 2008-01-28 |
| 1023201084 | St Lukes Regional Medical Center | Clinic/Center | 100 E Idaho St Ste 200, Boise, ID 83712-6270 | 2007-08-23 |
| 1770586794 | St Lukes Regional Medical Center | Pharmacy | 190 E Bannock St, Boise, ID 83712-6241 | 2005-05-23 |
| 1003295452 | St Lukes Regional Medical Center | Dietitian, Registered | 1226 W River St, Boise, ID 83702-7049 | 2015-05-19 |
| 1093109100 | St Lukes Regional Medical Center | Clinical Medical Laboratory | 3176 S Denver Way, Boise, ID 83705-5289 | 2015-03-26 |
| 1477954204 | St Lukes Regional Medical Center | Ambulance | 895 N 6th E, Mountain Home, ID 83647-2207 | 2014-09-11 |
| 1730505199 | St Lukes Regional Medical Center | Rehabilitation Unit | 600 N Robbins Rd, Boise, ID 83702-4565 | 2014-03-10 |
| 1093131450 | St Lukes Regional Medical Center | Skilled Nursing Facility | 600 N Robbins Rd, Boise, ID 83702-4565 | 2014-03-10 |
| 1326388737 | St Lukes Regional Medical Center | Surgery | 895 N 6th E, Mountain Home, ID 83647-2207 | 2013-02-21 |
| 1710226451 | St Lukes Regional Medical Center | Medicare Defined Swing Bed Unit | 895 N 6th E, Mountain Home, ID 83647-2207 | 2013-01-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST LUKES REGIONAL MEDICAL CENTER SIOUX CITY | 2720 Stone Park Blvd, Sioux City, IA 51104-3734 |
| Street Address |
520 S EAGLE RD SUITE 3102 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-6351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356348015 | Robert E. Holland Jr. | Family Medicine | 520 S Eagle Rd, Ste 1241, Meridian, ID 83642-6351 | 2005-07-07 |
| 1659984284 | Heather R Zimmerman | Occupational Therapist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-08-24 |
| 1619587573 | Maria Herbison | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-08-05 |
| 1952927543 | Grayson T Kendall | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-06-19 |
| 1891310371 | David Joseph Matthews | Respiratory Therapist, Registered | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-06-10 |
| 1356960603 | Rebecca Finder | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-04-15 |
| 1982231023 | Stephen Blake Miltner | Physical Therapist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-03-26 |
| 1093342834 | Clayton Hawks | Nurse Practitioner | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-03-23 |
| 1912547647 | Emily Tyler Getlein Marques | Nurse Practitioner | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-01-10 |
| 1184264244 | Jordan Leach | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642 | 2020-01-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174798334 | Don S Davis Md Pa | Clinic/Center | 5002 Hwy 39 N Bldg A, Meridian, MS 39301-1078 | 2008-04-28 |
| 1265903736 | Poole Joint Replacement Specialists | Clinic/Center | 2365 E Gala St Ste 1, Meridian, ID 83642-4881 | 2018-12-10 |
| 1932553245 | Saul Dermatology Pa | Clinic/Center | 5002 Highway 39 N Bldg A, Meridian, MS 39301-1078 | 2016-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902366834 | Pain & Spine Consultants | Clinic/Center | 1344 Hiland Avenue, Ste A, Burley, ID 83318 | 2019-03-25 |
| 1982015822 | Kenneth C Romney Md Inc | Clinic/Center | 526 Shoup Ave W Ste E, Twin Falls, ID 83301-5050 | 2014-05-14 |
| 1588802391 | Alpine Dermatology Clinic P.C. | Clinic/Center | 1049 Summers Dr, Rexburg, ID 83440-5335 | 2009-02-02 |
| 1275715559 | Dr. James D. Tanner, D.c., P.a. | Clinic/Center | 6070 E Sagewood Dr, Idaho Falls, ID 83406-5077 | 2007-11-29 |
| 1023201084 | St Lukes Regional Medical Center | Clinic/Center | 100 E Idaho St Ste 200, Boise, ID 83712-6270 | 2007-08-23 |
| 1750371894 | David N. Sim, M.d.,p.a. | Clinic/Center | 6014 W Emerald St, Boise, ID 83704-8855 | 2005-10-27 |
| 1740812320 | Back To Health Chiropractic LLC | Clinic/Center | 60 S 2nd W, Rexburg, ID 83440-1819 | 2020-02-11 |
| 1891104014 | Idaho Joint and Spine, PC | Clinic/Center | 9510 W Fairview Ave, Boise, ID 83704-8103 | 2014-08-13 |
| 1477897726 | James Rex Cutler Dpm Pllc | Clinic/Center | 76 E 1st S, Rexburg, ID 83440-1936 | 2012-11-26 |
| 1669727400 | Essential Life Boise, LLC | Clinic/Center | 13125 W Persimmon Ln, Suite 100, Boise, ID 83713 | 2012-07-18 |
| Find all providers with the same taxonomy | ||||
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| 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.