ST LUKE'S REGIONAL MEDICAL CENTER


Address: 100 E Idaho St, Ste 200, Boise, ID 83712-6267
Phone: 2083815000

ST LUKE'S REGIONAL MEDICAL CENTER (NPI# 1316243330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1316243330
Entity Type Organization
Organization Name ST LUKE'S REGIONAL MEDICAL CENTER
Other Organization Name ST LUKE'S CHILDRENS - NEUROLOGY
Practice Address 100 E Idaho St
Ste 200
Boise
ID 83712-6267
Mailing Address 190 E Bannock St
Boise
ID 83712-6241
Practice Telephone 2083815000
Practice Fax Number 2083815005
Mailing Telephone 2083812222
Enumeration Date 2011-02-09
Last Update Date 2011-02-09
Authorized Official Name JOHN KEE (VP PHYSICIAN SERVICES)
Authorized Official Telephone 2083815329
Is Organization Subpart Y
Parent Organization Name ST LUKE'S REGIONAL MEDICAL CENTER

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 103TC2200X Psychologist
Specialization: Clinical Child & Adolescent
03 ID Behavioral Health & Social Service Providers
Y 2080P0008X Pediatrics
Specialization: Neurodevelopmental Disabilities
03 ID Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
ST LUKE'S CHILDRENS - NEUROLOGY Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1548365919 St Luke's Regional Medical Center Hospice Care, Community Based 3330 E Louise Dr Ste 400, Meridian, ID 83642-5123 2006-09-13
1306149919 St Luke's Regional Medical Center Nurse Practitioner 3090 E Gentry Way, Ste 200, Meridian, ID 83642-3501 2010-12-21
1205137379 St Luke's Regional Medical Center Internal Medicine 600 W Robbins Rd, Ste 401, Boise, ID 83702-4565 2010-11-05
1801197082 St Luke's Regional Medical Center Pediatrics 100 E Idaho St, Ste 316, Boise, ID 83712-6267 2010-11-04
1386963205 St Luke's Regional Medical Center Obstetrics & Gynecology 100 E Idaho St, Suite 400, Boise, ID 83712-6267 2010-05-18
1659699841 St Luke's Regional Medical Center Surgery 333 N 1st St, Ste 280, Boise, ID 83702-6100 2010-05-12
1801113329 St Luke's Regional Medical Center Internal Medicine 403 S 11th St, Ste 100, Boise, ID 83702-6969 2010-04-23
1821314584 St Luke's Regional Medical Center Orthopaedic Surgery 520 S Eagle Rd, Suite 3213, Meridian, ID 83642-6351 2010-04-20
1184958936 St Luke's Regional Medical Center Family Medicine 130 E Boise Ave, Boise, ID 83706-4302 2009-09-28
1962606376 St Luke's Regional Medical Center Family Medicine 520 S Eagle Rd, Suite 3201, Meridian, ID 83642-6308 2007-06-12

Office Location

Street Address 100 E IDAHO ST
STE 200
City BOISE
State ID
Zip Code 83712-6267

Providers in the same location

NPI Name Taxonomy Address Enumeration
1336133776 Gregory G Janos Pediatrics 100 E Idaho St, Suite 200, Boise, ID 83712-6267 2005-08-31
1205444734 Allison Reed Pharmacist 100 E Idaho St, Boise, ID 83712-6267 2020-07-21
1619585247 Christina Gullion Pharmacist 100 E Idaho St, Boise, ID 83712-6267 2020-07-20
1548897556 Brooke Hueftle Pharmacist 100 E Idaho St, Boise, ID 83712-6267 2020-03-27
1194364919 Sarah Rosemarie Hogue Pharmacist 100 E Idaho St, Boise, ID 83712-6267 2019-12-26
1710525167 Leslie Lynn Lamontagne Pharmacist 100 E Idaho St, Boise, ID 83712-6267 2019-12-17
1487292843 Lauren Zupsic Pharmacist 100 E Idaho St, Boise, ID 83712-6267 2019-12-17
1659919199 Stephanie Matta Pharmacist 100 E Idaho St, Boise, ID 83712-6267 2019-12-16
1104464627 David Blair Wilson Pharmacist 100 E Idaho St, Boise, ID 83712-6267 2019-12-16
1386282788 Jessie Modlin Pharmacist 100 E Idaho St, Boise, ID 83712-6267 2019-12-16
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477016012 Veranda At Barber Station LLC Assisted Living Facility 3266 E. Barber Valley Drive, Boise, ID 83712 2019-04-10
1891258612 Mary Elizabeth Riedel Occupational Therapist 190 E Bancock St., Boise, ID 83712 2019-04-09
1427523968 Q17 Health Partners LLC Surgery 100 East Idaho Street #317, Boise, ID 83712 2018-10-11
1053898247 Travis Dale Worwood Social Worker South Entrance, 1075 E. Park Blvd, Boise, ID 83712 2018-07-20
1689166761 Kristen Nicole Ray Social Worker 109 E Bannock St, Boise, ID 83712 2018-06-04
1740706894 Meghan Heitstuman Social Worker 190 E Bannock Street, Boise, ID 83712 2017-08-21
1942759725 Kay Craig Physical Therapist 190 Bannock, Boise, ID 83712 2016-09-22
1235686395 Sharon Bjornson Physical Therapist 190 East Bannack, Boise, ID 83712 2016-09-07
1033576491 Heather Hussey Genetic Counselor, MS 100 E Idaho Street, Msti Genetics, Boise, ID 83712 2016-01-15
1295139137 Amie Bartholomeus Massage Therapist 100 East Idaho Street, St Luke's Mountain States Tumor Institute, Boise, ID 83712 2014-10-21
Find all providers in zip 83712

Taxonomy Information

Taxonomy Code 2080P0008X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Neurodevelopmental Disabilities

Taxonomy Definition

A pediatrician who treats children having developmental delays or learning disorders including those associated with visual and hearing impairment, mental retardation, cerebral palsy, spina bifida, autism and other chronic neurologic conditions. This specialist provides medical consultation and education and assumes leadership in the interdisciplinary management of children with neurodevelopmental disorders. They may also focus on the early identification and diagnosis of neurodevelopmental disabilities in infants and young children as well as on changes that occur as the child with developmental disabilities grows.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1417012022 Carol Klett Vance Pediatrics 1619 Curlew Dr Ste 6, Ammon, ID 83406-4719 2006-12-26
1346410321 Carol Klett Vance Md, Inc. Pediatrics 1619 Curlew Dr, Suite 6, Ammon, ID 83406-4719 2008-03-06

Competitor

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City BOISE
Zip Code 83712

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Dataset Information

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.

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