ST LUKE'S MCCALL LTD (NPI# 1770886384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770886384 |
| Entity Type | Organization |
| Organization Name | ST LUKE'S MCCALL LTD |
| Other Organization Name | ST LUKE'S PAYETTE LAKES MEDICAL CLINIC |
| Practice Address |
211 Forest St Mccall ID 83638-5256 |
| Practice Telephone | 2086342225 |
| Mailing Telephone | 2086342225 |
| Enumeration Date | 2010-12-21 |
| Last Update Date | 2010-12-21 |
| Authorized Official Name | JEFF TAYLOR (SYSTEM VP CFO) |
| Authorized Official Telephone | 2083812520 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST LUKE'S MCCALL LTD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | 11 | ID | Allopathic & Osteopathic Physicians |
| N | 363L00000X | Nurse Practitioner | 11 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207Q00000X | Family Medicine | 11 | ID | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| St Luke's Payette Lakes Medical Clinic | Doing Business As Name - Organization |
| Street Address |
211 FOREST ST |
| City | MCCALL |
| State | ID |
| Zip Code | 83638-5256 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992743215 | Bill Stahlberg | Physician Assistant | 211 Forest St, Mccall, ID 83638-5256 | 2006-06-02 |
| 1245503614 | St Lukes Mccall Ltd | Family Medicine | 211 Forest St, Mccall, ID 83638-5256 | 2012-02-16 |
| 1508153784 | Karl F Johnson | Pharmacist | 211 Forest St, Mccall, ID 83638-5256 | 2011-07-07 |
| 1902948516 | David A. Hall | Family Medicine | 211 Forest St, Mccall, ID 83638-5256 | 2007-02-12 |
| 1689715864 | Eddie Droge | Family Medicine | 211 Forest St, Mccall, ID 83638 | 2007-02-09 |
| 1669513859 | Scott S. Harris | Family Medicine | 211 Forest St, Mccall, ID 83638-5256 | 2007-02-09 |
| 1487795605 | Julie L. Welty | Family Medicine | 211 Forest St, Mccall, ID 83638 | 2007-02-09 |
| 1538258850 | Sarah A. Curtin | Family Medicine | 211 Forest St, Mccall, ID 83638-1047 | 2006-10-12 |
| 1295764405 | Caitlin J. Gustafson | Family Medicine | 211 Forest St, Mccall, ID 83638 | 2006-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255897708 | Seanne Jo Safaii | Dietitian, Registered | 1100 Heaven's Gate Ct. #1910, Mccall, ID 83638 | 2019-02-20 |
| 1053881284 | Debra Ann Jones Yensen | Counselor | 1242 Herrick Street N, Mccall, ID 83638 | 2018-11-30 |
| 1306369681 | Cheyene Joseph Nickerson | Pharmacist | 132 East Lake Street, Mccall, ID 83638 | 2017-07-19 |
| 1669923892 | Amy Leigh Forkan | Massage Therapist | 301 E Park St., Mccall, ID 83638 | 2016-10-24 |
| 1770982597 | Rachel L Smith | Acupuncturist | 106 E. Park St, Suite 102, Mc Call, ID 83638 | 2014-08-18 |
| 1275944498 | Central Idaho Counseling, Pllc | Social Worker | 125 Commerce St., Suite B, Mccall, ID 83638 | 2014-05-09 |
| 1548690829 | Sze Wan Chan | Pharmacist | 1001 North 2nd Street, Mccall, ID 83638 | 2013-11-22 |
| 1467882274 | Tamara Nagoda | Speech-Language Pathologist | 304 Edgewater Circle, Mccall, ID 83638 | 2013-11-14 |
| 1457537896 | Thomas L Moore | Counselor | 310 E. Lake St., Tom Moore, Mccall, ID 83638 | 2008-01-16 |
| 1659581585 | Barbara Gail Norton | Social Worker | 125 Commerce St, Suite B, Mccall, ID 83638 | 2007-05-22 |
| Find all providers in zip 83638 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144301664 | James W Dardis | Family Medicine | 211 Forest St., Mccall, ID 83638-1047 | 2006-10-18 |
| 1922482470 | Katrina M. Mckellips | Family Medicine | 209 Forest St, Mccall, ID 83638-5256 | 2015-07-15 |
| 1912224890 | Jonathan M Currey | Family Medicine | 1000 State St, Mccall, ID 83638-3704 | 2010-04-30 |
| 1902948516 | David A. Hall | Family Medicine | 211 Forest St, Mccall, ID 83638-5256 | 2007-02-12 |
| 1861533135 | Daniel P. Ostermiller | Family Medicine | 211 Forest St., Mccall, ID 83638 | 2007-02-09 |
| 1689715864 | Eddie Droge | Family Medicine | 211 Forest St, Mccall, ID 83638 | 2007-02-09 |
| 1669513859 | Scott S. Harris | Family Medicine | 211 Forest St, Mccall, ID 83638-5256 | 2007-02-09 |
| 1487795605 | Julie L. Welty | Family Medicine | 211 Forest St, Mccall, ID 83638 | 2007-02-09 |
| 1538258850 | Sarah A. Curtin | Family Medicine | 211 Forest St, Mccall, ID 83638-1047 | 2006-10-12 |
| 1295764405 | Caitlin J. Gustafson | Family Medicine | 211 Forest St, Mccall, ID 83638 | 2006-07-01 |
| Find all providers in MCCALL | ||||
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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.