ST LUKES REGIONAL MEDICAL CENTER (NPI# 1699013565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699013565 |
| Entity Type | Organization |
| Organization Name | ST LUKES REGIONAL MEDICAL CENTER |
| Other Organization Name | ST LUKES ELMORE MEDICAL CENTER |
| Practice Address |
895 N 6th E Mountain Home ID 83647-2207 |
| Mailing Address |
Po Box 2777 Boise ID 83701-2777 |
| Practice Telephone | 2085878401 |
| Mailing Telephone | 2087065000 |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2015-02-17 |
| Authorized Official Name | JEFF TAYLOR (CFO/SYSTEM VP) |
| Authorized Official Telephone | 2083812520 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
ID | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS | 00406 | 01 | |
| BLUE SHIELD | 000010148578 | 01 |
| Other Name | Type Code |
|---|---|
| ST LUKES ELMORE MEDICAL CENTER | 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 |
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 | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417122821 | Elmore Medical Center Specialty Physician Group | General Acute Care Hospital | 890 N 6th E, Mountain Home, ID 83647-2206 | 2008-04-25 |
| 1518962273 | Elmore Medical Center Hospital District | General Acute Care Hospital | 895 North 6th East, Mountain Home, ID 83647 | 2005-06-17 |
| 1760506851 | Elmore Medical Center Hospital District | General Acute Care Hospital | 895 N 6th E, Mountain Home, ID 83647-2207 | 2007-03-16 |
| 1053472845 | Elmore Medical Center | General Acute Care Hospital | 895 N 6th E, Mountain Home, ID 83647 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851761464 | Brent Leavitt | General Acute Care Hospital | 4928 Pleasant View Dr, Chubbuck, ID 83202-1640 | 2015-09-25 |
| 1053669598 | Teton Valley Health Care, Inc | General Acute Care Hospital | 120 E Howard Avenue, Driggs, ID 83422-5112 | 2012-08-15 |
| 1639406267 | Florence Hospital, LLC | General Acute Care Hospital | 1300 E State St, Suite 102, Eagle, ID 83616-7059 | 2009-11-03 |
| 1912132176 | Initiatives Healthcare, LLC | General Acute Care Hospital | 1205 N 11th St, Boise, ID 83702-4102 | 2009-05-18 |
| 1275703241 | North Canyon Medical Center, Inc. | General Acute Care Hospital | 267 North Canyon Drive, Gooding, ID 83330-1858 | 2008-03-06 |
| 1720298102 | Weiser Valley Hospital District | General Acute Care Hospital | 645 E. 5th Street, Weiser, ID 83672-2202 | 2007-05-23 |
| 1548320435 | Benewah Community Hospital | General Acute Care Hospital | 229 South 7th St, St Maries, ID 83861 | 2006-12-11 |
| 1295769537 | Gooding County Hospital District | General Acute Care Hospital | 1120 Montana St, Gooding, ID 83330-1858 | 2006-07-11 |
| 1881641629 | Weiser Valley Hospital District | General Acute Care Hospital | 645 E. 5th St., Weiser, ID 83672-2202 | 2006-05-27 |
| 1609826270 | Oneida County Hospital | General Acute Care Hospital | 150 N 200 W, Malad, ID 83252-1239 | 2006-05-12 |
| Find all providers with the same taxonomy | ||||
| City | MOUNTAIN HOME |
| Zip Code | 83647 |
Please comment or provide details below to improve the information on ST LUKES REGIONAL MEDICAL CENTER.
| 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.