ST LUKES REGIONAL MEDICAL CENTER (NPI# 1326388737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326388737 |
| Entity Type | Organization |
| Organization Name | ST LUKES REGIONAL MEDICAL CENTER |
| Other Organization Name | ST LUKES ELMORE MEDICAL CENTER PHYSICIAN GROUP |
| Practice Address |
895 N 6th E Mountain Home ID 83647-2207 |
| Mailing Address |
190 E Bannock St Boise ID 83712-6241 |
| Practice Telephone | 2085878401 |
| Practice Fax Number | 2085878406 |
| Mailing Telephone | 2083812222 |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2016-06-22 |
| Authorized Official Name | JEFF TAYLOR (SYSTEM VP CFO) |
| Authorized Official Telephone | 2083812520 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST LUKES REGIONAL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 03 | ID | Allopathic & Osteopathic Physicians |
| Y | 207P00000X | Emergency Medicine | 03 | ID | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| St Lukes Elmore Medical Center Physician Group | 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 |
| 1710226451 | St Lukes Regional Medical Center | Medicare Defined Swing Bed Unit | 895 N 6th E, Mountain Home, ID 83647-2207 | 2013-01-31 |
| 1508105248 | St Lukes Regional Medical Center | Skilled Nursing Facility | 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 |
895 N 6TH E |
| City | MOUNTAIN HOME |
| State | ID |
| Zip Code | 83647-2207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184620791 | Elmore Medical Center Hospital District | Skilled Nursing Facility | 895 N 6th E, Mountain Home, ID 83647-2207 | 2005-06-28 |
| 1710525274 | Kory Dell Olaveson | Pharmacist | 895 N 6th E, Mountain Home, ID 83647-2207 | 2019-12-16 |
| 1083141345 | Shelby Rae Lunday | Occupational Therapist | 895 N 6th E, Mountain Home, ID 83647-2207 | 2017-05-17 |
| 1346790409 | Regina Ugrinsky | Specialist | 895 N 6th E, Mountain Home, ID 83647-2207 | 2016-10-12 |
| 1811361231 | Melissa Cobb | Physical Therapy Assistant | 895 N 6th E, Mountain Home, ID 83647-2207 | 2015-11-23 |
| 1528435666 | Stacey Mcfarland-smith | Occupational Therapist | 895 N 6th E, Mountain Home, ID 83647-2207 | 2015-08-24 |
| 1396148029 | Angela Hale | Physical Therapy Assistant | 895 N 6th E, Mountain Home, ID 83647-2207 | 2014-10-08 |
| 1477954204 | St Lukes Regional Medical Center | Ambulance | 895 N 6th E, Mountain Home, ID 83647-2207 | 2014-09-11 |
| 1326455874 | Christian Jackson | Occupational Therapist | 895 N 6th E, Mountain Home, ID 83647-2207 | 2014-07-16 |
| 1528483211 | Christopher Stainberg | Physical Therapy Assistant | 895 N 6th E, Mountain Home, ID 83647-2207 | 2014-03-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528684370 | The Unruly Tongue Myofunctional Therapy LLC | Specialist | 1125 Nw Bluegrass Cir, Mountain Home, ID 83647 | 2020-06-17 |
| 1740767284 | Kelly Loy | Counselor | 210 North 3rd East, Mountain Home, ID 83647 | 2018-07-27 |
| 1891247912 | Daelene Sueann Tibbitts | Physical Therapy Assistant | 1665 E 5th N, Mountain Home, ID 83647 | 2016-10-25 |
| 1689065765 | Emma Orthel | Counselor | 2240 American Legion Blvd, Mountain Home, ID 83647 | 2015-02-11 |
| 1073692166 | Krzysztof Hendryk Ziola | Internal Medicine | 2280 American Legion Blvd., Mountain Home, ID 83647 | 2006-11-02 |
| 1952482440 | Michael Peter Koelsch | Internal Medicine | 805 North 6th East, Mountain Home, ID 83647 | 2006-10-18 |
| 1124113709 | Talmage W Delange | Counselor | 235 North 3rd East, Mountain Home, ID 83647 | 2006-10-03 |
| 1225044019 | Scott W Sessions | Physical Therapist | 245 N. 3rd, Mountain Home, ID 83647 | 2006-07-31 |
| 1750370730 | Kyle J Kenison | Optometrist | 855 West 6th South, Mountain Home, ID 83647 | 2005-10-21 |
| 1285628156 | Bruce Joseph Siedlecki | Obstetrics & Gynecology | Mtn.home Aif Force Base, Mdos, Mtn. Home, ID 83647 | 2005-09-07 |
| Find all providers in zip 83647 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750305322 | Jonathan W Wireman | Emergency Medicine | Corner Lamont and Veterans Way, Mountain Home, TN 37684 | 2006-07-27 |
| 1215999016 | Sharon Jamie Pritchard | Emergency Medicine | 630 Burnett Drive, Mountain Home, AR 72653-2941 | 2006-04-05 |
| 1891146403 | Caleb Joseph Pingel | Emergency Medicine | 624 Hospital Dr, Mountain Home, AR 72653-2955 | 2016-06-24 |
| 1295103364 | Michelle M Godfrey Pa | Emergency Medicine | 901 Burnett Dr, Mountain Home, AR 72653-2908 | 2015-09-08 |
| 1922488014 | Medexpress Urgent Care Arkansas, P.a. | Emergency Medicine | 305 Highway 62 E, Mountain Home, AR 72653-3655 | 2015-06-03 |
| 1245560424 | Baxter Emergency Group Pllc | Emergency Medicine | 624 Hospital Dr, Mountain Home, AR 72653-2955 | 2010-01-11 |
| 1417191248 | Bradley Dale Schulz | Emergency Medicine | 624 Hospital Dr, Mountain Home, AR 72653-2955 | 2009-04-23 |
| 1659548790 | Dana L Kinney | Emergency Medicine | 624 Hospital Dr, Mountain Home, AR 72653 | 2008-05-08 |
| 1023280062 | Billy Gene Bisswanger | Emergency Medicine | 624 Hospital Dr, Mountain Home, AR 72653 | 2008-03-31 |
| 1295894442 | Mark D West | Emergency Medicine | 624 Hospital Dr, Mountain Home, AR 72653-2955 | 2006-12-06 |
| Find all providers in MOUNTAIN HOME | ||||
| City | MOUNTAIN HOME |
| Zip Code | 83647 |
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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.