NPIMap

Organization Active NPI

St Lukes Regional Medical Center

Doing business as St Lukes Mountain View Medical Center

  • Family Medicine Physician
  • Boise, ID
National Provider Identifier
1063660645
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
03 Issued in ID
Legal business name
ST LUKES REGIONAL MEDICAL CENTER
Doing business as
St Lukes Mountain View Medical Center
Practice address
3301 N Sawgrass Way
Boise, ID 83704-4493
Phone
(208) 375-0862
NPI assigned
Sep 8, 2008
Last updated
Sep 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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

Authorized official

Name
Sandy Stevenson
Title
Manager
Phone
(208) 375-0862

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 03 ID Primary

Addresses

Primary practice location

3301 N Sawgrass Way
Boise, ID 83704-4493

Mailing address

3301 N Sawgrass Way
Boise, ID 83704-4493
Phone (208) 375-0862

Other names 1

  • ST LUKES MOUNTAIN VIEW MEDICAL CENTER Doing business as

National Provider Directory

National Provider Directory

Locations

3301 N Sawgrass Way
Boise, ID 83704
Phone (208) 375-0862

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1063660645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 N SAWGRASS WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044493",
            "telephone_number": "208-375-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 N SAWGRASS WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044493",
            "telephone_number": "208-375-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "STEVENSON",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "208-375-0862"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "03",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST LUKES MOUNTAIN VIEW MEDICAL CENTER",
            "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 Sep 8, 2008; 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.