ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTD (NPI# 1730511254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1730511254 |
Entity Type | Organization |
Organization Name | ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTD |
Other Organization Name | ST LUKES JEROME SWING BEDS |
Practice Address |
709 N Lincoln Ave Jerome ID 83338-1851 |
Mailing Address |
Po Box 2777 Boise ID 83701-2777 |
Practice Telephone | 2083244301 |
Mailing Telephone | 2087065000 |
Enumeration Date | 2013-08-07 |
Last Update Date | 2018-11-28 |
Authorized Official Name | JEFF TAYLOR (CFO, VP FINANCE) |
Authorized Official Telephone | 2083812520 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 275N00000X | Medicare Defined Swing Bed Unit | 08 | ID | Hospital Units |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ID | 806199500 | 05 |
Other Name | Type Code |
---|---|
ST LUKES JEROME SWING BEDS | 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 |
1164469870 | St Lukes Magic Valley Regional Medical Center Ltd | Psychiatric Unit | 228 Shoup Ave W, Twin Falls, ID 83301-5022 | 2006-06-01 |
1881224327 | St Lukes Magic Valley Regional Medical Center Ltd | Pharmacy | 801 Pole Line Rd W, Twin Falls, ID 83301-5810 | 2020-01-23 |
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 |
709 N LINCOLN AVE |
City | JEROME |
State | ID |
Zip Code | 83338-1851 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336138783 | Brian Lee Johnson | Family Medicine | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2005-10-18 |
1609414051 | Troy M Jackman | Pharmacist | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2019-12-17 |
1891165569 | Anne B Fullmer | Nurse Practitioner | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2015-10-06 |
1366874877 | St Luke's Magic Valley Regional Medical Center Ltd | General Acute Care Hospital | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2013-08-07 |
1912137175 | Paul A Dickinson | Nurse Anesthetist, Certified Registered | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2009-07-22 |
1700053774 | St Benedicts Fmc Physician Assistants | Physician Assistant | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2008-05-09 |
1083833933 | Thomas Henry Zepeda | Personal Emergency Response Attendant | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2007-04-25 |
1639211634 | St. Benedicts Family Medical Center | Long Term Care Hospital | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2007-02-13 |
1750489647 | Richard Emery Lally | Emergency Medicine | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2006-09-21 |
1902856727 | St Benedicts Family Medical Center | Skilled Nursing Facility | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2006-05-11 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295336709 | Family Health Services Pharmacy | Pharmacy | 218 W. Nez Perce, Jerome, ID 83338 | 2020-11-03 |
1811391626 | Summit Therapy Services | In Home Supportive Care | 113 East Ave. F, Jerome, ID 83338 | 2014-10-22 |
1952645285 | Readings Community Pharmacy Inc | Pharmacy | 133 West A, Jerome, ID 83338 | 2012-11-27 |
1801121298 | Yolanda S. Sedano | Physician Assistant | 132 5th Ave West, Jerome, ID 83338 | 2009-10-02 |
1295898310 | Ronald Gail Hendrickson | Dentist | 128 South Adams, Jerome, ID 83338 | 2006-12-19 |
1316035512 | Johnson Chiropractic Clinic | Chiropractor | 600 N Lincoln Ave, Jerome, ID 83338 | 2006-10-11 |
1265527725 | Lon M. Egbert, P.C. | Specialist/Technologist | 128 5th Ave West, Jerome, ID 83338 | 2006-10-03 |
1992898605 | St Benedicts Family Medical Center | Home Health | 414 N Lincoln, Suite 1, Jerome, ID 83338 | 2006-10-02 |
1790231355 | Lexa Marie Balling | Pharmacist | 2680 S Lincoln Ave, Jerome, ID 83338 | 2016-09-01 |
1922037530 | St Benedicts Family Medical Center | Clinic/Center | 115 5th Ave W, Jerome, ID 83338-1824 | 2006-07-03 |
Find all providers in zip 83338 |
Taxonomy Code | 275N00000X |
Grouping | Hospital Units |
Classification | Medicare Defined Swing Bed Unit |
A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
Notes: Source: Code of Federal Regulations #42, Section 482.66. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992913479 | Steele Memorial Medical Center | Medicare Defined Swing Bed Unit | 203 S. Daisy St., Salmon, ID 83467 | 2007-05-18 |
1710226451 | St Lukes Regional Medical Center | Medicare Defined Swing Bed Unit | 895 N 6th E, Mountain Home, ID 83647-2207 | 2013-01-31 |
1043528011 | St Lukes Mccall, Ltd | Medicare Defined Swing Bed Unit | 1000 State St, Mccall, ID 83638-3704 | 2010-09-23 |
1689876781 | Bmh Inc | Medicare Defined Swing Bed Unit | 98 Poplar St, Blackfoot, ID 83221-1758 | 2007-06-01 |
1043429327 | Bingham Memorial Hospital | Medicare Defined Swing Bed Unit | 98 Poplar St, Blackfoot, ID 83221-1758 | 2007-05-22 |
1700909983 | Walter Knox Memorial Hospital | Medicare Defined Swing Bed Unit | 1202 E Locust St, Emmett, ID 83617-2715 | 2007-04-10 |
1275662546 | St Lukes Medical Center Woodriver Ltd | Medicare Defined Swing Bed Unit | 100 Hospital Drive, Ketchum, ID 83340-9999 | 2007-03-05 |
1619039732 | Mccall Memorial Hospital | Medicare Defined Swing Bed Unit | 1000 State St, Mccall, ID 83638-3704 | 2006-12-14 |
1740341114 | Gooding County Hospital District | Medicare Defined Swing Bed Unit | 1120 Montana St, Gooding, ID 83330-1858 | 2006-12-12 |
1598825028 | Caribou Memorial Hospital | Medicare Defined Swing Bed Unit | 300 S 3rd W, Soda Springs, ID 83276-1559 | 2006-12-12 |
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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.