NPIMap

Organization Active NPI

St Lukes Regional Medical Center

Doing business as St Lukes Internal Medicine

  • Medical Specialty Clinic/Center
  • Boise, ID
National Provider Identifier
1013957471
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
ST LUKES REGIONAL MEDICAL CENTER
Doing business as
St Lukes Internal Medicine
Practice address
4840 N Cloverdale Rd
Boise, ID 83713-2423
Phone
(208) 706-8000
Fax
(208) 706-8001
NPI assigned
Jun 7, 2006
Last updated
Oct 31, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carrie Lynne Cowgill
Title
Credentialing Coordinator
Phone
(208) 381-4137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

4840 N Cloverdale Rd
Boise, ID 83713-2423

Mailing address

PO Box 550
Boise, ID 83701-0550
Phone (208) 706-8000

Other names 1

  • ST LUKES INTERNAL MEDICINE Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1013957471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837010550",
            "telephone_number": "208-706-8000",
            "fax_number": "208-706-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 N CLOVERDALE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837132423",
            "telephone_number": "208-706-8000",
            "fax_number": "208-706-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "COWGILL",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "208-381-4137"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST LUKES INTERNAL MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.