ST LUKES REGIONAL MEDICAL CENTER (NPI# 1639356173) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639356173 |
| Entity Type | Organization |
| Organization Name | ST LUKES REGIONAL MEDICAL CENTER |
| Other Organization Name | ST LUKES MEDICAL CLINIC @ HP |
| Practice Address |
11311 W Chinden Blvd Boise ID 83714-1021 |
| Mailing Address |
Po Box 550 Boise ID 83701-0550 |
| Practice Telephone | 2083814120 |
| Mailing Telephone | 2083814120 |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2008-01-28 |
| Authorized Official Name | SHANNA RICHTER (MANAGER) |
| Authorized Official Telephone | 2083814120 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 03 | ID | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| ST LUKES MEDICAL CLINIC @ HP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1508105248 | St Lukes Regional Medical Center | Skilled Nursing Facility | 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 |
11311 W CHINDEN BLVD |
| City | BOISE |
| State | ID |
| Zip Code | 83714-1021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831468651 | Crump Enterprises | Point of Service | 11311 W Chinden Blvd, Boise, ID 83714-1021 | 2011-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932683752 | Ikdo State Street LLC | Dentist | 9209 W State St, Garden City, ID 83714 | 2018-09-18 |
| 1437608007 | Carrie Boroughs Breaux | Ophthalmology | 5019 N Sawyer Ave, Garden City, ID 83714 | 2016-09-23 |
| 1841646007 | Alliance Medical Group, LLC | Family Medicine | 5601 W. Chinden Blvd., Garden City, ID 83714 | 2016-05-06 |
| 1134580467 | Rebecca Gillet | Physical Therapist | 6576 W Dufferin Ct, Boise, ID 83714 | 2016-03-15 |
| 1063816007 | Ingri Suzanne Koloski | Counselor | 8969 West Hepburn Lane, Garden City, ID 83714 | 2014-10-20 |
| 1679909329 | Anile Nina | Counselor | 5484 N Gary Lane, Boise, ID 83714 | 2013-09-25 |
| 1215360292 | William Blake Bybee | Dentist | 5833 W. Hidden Springs Dr., Boise, ID 83714 | 2013-08-14 |
| 1871833327 | Charmaine Read | Social Worker | 123 E. 44th St, Ste. A, Garden City, ID 83714 | 2013-02-20 |
| 1811206576 | Bennett Medical Services | Durable Medical Equipment & Medical Supplies | 5220 Sawyer Court, Suite D, Garden City, ID 83714 | 2010-09-29 |
| 1073780680 | Barry Lynn Williams | Pharmacist | 7020 W State Street, Boise, ID 83714 | 2008-05-13 |
| Find all providers in zip 83714 | ||||
| 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 |
|---|---|---|---|---|
| 1790269389 | Erin Michelle Love Mcdermott | Family Medicine | 2402 W Jefferson St, Boise, ID 83702-4811 | 2018-09-19 |
| 1336656040 | Functional Medicine of Idaho PC | Family Medicine | 3858 N Garden Center Way Ste 100, Boise, ID 83703-5008 | 2018-01-03 |
| 1922456870 | Daniel Luftig | Family Medicine | 1041 S Dale St Apt 302, Boise, ID 83706-7641 | 2016-06-01 |
| 1942676598 | Robert F. Smith, Md, Pllc | Family Medicine | 320 N Collins Rd, Boise, ID 83702-4519 | 2015-08-18 |
| 1861827222 | Treasure Valley Neuropathy Relief Center PC | Family Medicine | 1755 N Westgate Dr, Suite 200, Boise, ID 83704-7174 | 2013-09-04 |
| 1205272986 | Shahla Walizada | Family Medicine | 2141 E Parkcenter Blvd, Samg Bhp Family Medicine, Boise, ID 83706 | 2013-05-21 |
| 1891057246 | Kara Mackenzie Kuntz | Family Medicine | 5966 W Curtisian Road, Boise, ID 83704 | 2012-06-12 |
| 1922366707 | Cottonwood Family Medicine | Family Medicine | 100 Cottonwood Court, Suite 150, Boise, ID 87616 | 2012-04-30 |
| 1720377476 | Steven Schneider | Family Medicine | 3775 W Quail Hollow Dr, Boise, ID 83703-3869 | 2011-04-04 |
| 1922311042 | Amber Vania | Family Medicine | 4971 W. Overland Road, Boise, ID 83705 | 2010-07-18 |
| Find all providers in BOISE | ||||
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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.