ST LUKES CLINIC-TREASURE VALLEY LLC (NPI# 1336442607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336442607 |
Entity Type | Organization |
Organization Name | ST LUKES CLINIC-TREASURE VALLEY LLC |
Other Organization Name | ST LUKES CLINIC - EASTERN OREGON MEDICAL ASSOCIATES |
Practice Address |
3950 17th St Baker City OR 97814-1300 |
Mailing Address |
Po Box 640 Boise ID 83701-0640 |
Practice Telephone | 5415231001 |
Mailing Telephone | 2083812222 |
Enumeration Date | 2010-12-08 |
Last Update Date | 2016-09-29 |
Authorized Official Name | JEFF TAYLOR (CFO, SYSTEM VP) |
Authorized Official Telephone | 2083812520 |
Authorized Official Credential | CFO |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207Q00000X | Family Medicine | 03 | ID | Allopathic & Osteopathic Physicians |
N | 207V00000X | Obstetrics & Gynecology | 03 | ID | Allopathic & Osteopathic Physicians |
N | 363LF0000X |
Nurse Practitioner Specialization: Family |
03 | ID | Physician Assistants & Advanced Practice Nursing Providers |
Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
03 | ID | Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
St Lukes Clinic - Eastern Oregon Medical Associates | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417297821 | St Lukes Clinic-treasure Valley LLC | Family Medicine | 465 Mckenna Dr, Mountain Home, ID 83647-2143 | 2013-02-21 |
Street Address |
3950 17TH ST |
City | BAKER CITY |
State | OR |
Zip Code | 97814-1300 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427046820 | J Daniel Smithson | Family Medicine | 3950 17th St, Suite A, Baker City, OR 97814-1300 | 2005-10-10 |
1073089298 | Laura Van Duker | Physician Assistant | 3950 17th St, Baker City, OR 97814-1300 | 2018-10-15 |
1487046785 | Colleen M Mcdonald | Social Worker | 3950 17th St, Baker City, OR 97814-1300 | 2015-02-23 |
1982009817 | Micah Thayn | Physician Assistant | 3950 17th St, Baker City, OR 97814-1300 | 2014-11-04 |
1023430493 | Lauren Zink | Dietitian, Registered | 3950 17th St, St # A, Baker City, OR 97814-1300 | 2014-01-20 |
1871835538 | St Lukes Clinic - Treasure Valley LLC | Durable Medical Equipment & Medical Supplies | 3950 17th St, Baker City, OR 97814-1300 | 2013-03-20 |
1508113366 | Devin S Bowman | Physician Assistant | 3950 17th St, Suite A, Baker City, OR 97814-1300 | 2012-08-12 |
1427348507 | Neil J Carroll | Family Medicine | 3950 17th St, Baker City, OR 97814-1300 | 2011-04-11 |
1437486875 | Monte W. Anderson | Physician Assistant | 3950 17th St, Ste A, Baker City, OR 97814-1300 | 2009-11-05 |
1487730479 | Karen C Andruss | Nurse Practitioner | 3950 17th St, Suite A, Baker City, OR 97814-1300 | 2006-10-31 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083279871 | Charles Henry Campos | Counselor | 2021 Court Street, Baker City, OR 97814 | 2019-05-07 |
1831546217 | Veronica Crowder | Physician Assistant | Samg Orthopedics Baker City, 3325 Pocahontas Rd, Baker City, OR 97814 | 2016-05-16 |
1013389956 | Dara Michelle Fields | Counselor | 2200 4th Street, Baker City, OR 97814 | 2015-10-29 |
1003223694 | Colleen Davenport | Nurse Practitioner | 3975 N Midway Dr, Baker City, OR 97814 | 2014-07-16 |
1629418363 | Sherry Melena Zacharias Forsyth | Counselor | 2100 Main St., New Directions, Baker City, OR 97814 | 2013-06-26 |
1609215573 | Logan Clay Frederickson | Family Medicine | 3820 17th Street, Baker City, OR 97814 | 2013-06-24 |
1790124485 | James Lee Morris | Counselor | 3610 Midway, Baker City, OR 97814 | 2013-06-17 |
1881955656 | New Directions Northwest, Inc | Substance Abuse Rehabilitation Facility | 3610 Midway Drive, Baker City, OR 97814 | 2012-06-07 |
1972864759 | New Directions Northwest, Inc. | Substance Abuse Rehabilitation Facility | 3700 Midway Drive, Baker City, OR 97814 | 2012-06-07 |
1659671113 | Al H Brickman | Pharmacist | 1205 Campbell St., Baker City, OR 97814 | 2010-10-29 |
Find all providers in zip 97814 |
Taxonomy Code | 261QR1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rural Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225375991 | Saint Alphonsus Medical Center -baker City, Inc | Clinic/Center | 3325 Pocahontas Rd, Baker City, OR 97814-1464 | 2013-01-14 |
1992734743 | Baker Clinic, LLP | Clinic/Center | 3175 Pocahontas Rd, Baker City, OR 97814-1434 | 2006-07-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770183063 | Praxis Medical Group P.C. | Clinic/Center | 1890 7th St., Umatilla, OR 97882 | 2020-10-27 |
1336749621 | Praxis Medical Group P.C. | Clinic/Center | 2011 Fourth St., La Grande, OR 97850 | 2020-10-27 |
1225694706 | Columbia Lutheran Charities | Clinic/Center | 1111 N Roosevelt Dr Ste 210, Seaside, OR 97138-4604 | 2019-05-10 |
1093296519 | Grande Ronde Hospital, Inc. | Clinic/Center | 10303 S Walton Rd, La Grande, OR 97850 | 2018-08-23 |
1285164921 | Northwest Medical Foundation of Tillamook | Clinic/Center | 1005 Cougar St, Vernonia, OR 97064-1282 | 2017-06-15 |
1043694342 | Grande Ronde Hospital, Inc | Clinic/Center | 570 8th, Elgin, OR 97827 | 2015-07-16 |
1992183859 | Centennial Medical Group East, LLC | Clinic/Center | 145 E. Broadway, Myrtle Creek, OR 97457 | 2015-05-12 |
1477945517 | Morrow County Health District | Clinic/Center | 365 W 3rd St, Ione, OR 97843-7216 | 2015-02-26 |
1699183236 | Lake Health District | Clinic/Center | 700 South J St, Lakeview, OR 97630 | 2014-07-28 |
1487919783 | Aurora Family Health and Maternity Care Services LLC | Clinic/Center | 21358 Hwy 99e Ne, Aurora, OR 97002 | 2012-07-12 |
Find all providers with the same taxonomy |
City | BAKER CITY |
Zip Code | 97814 |
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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.