NPIMap

Organization Active NPI

Saint Alphonsus Regional Medical Center Inc

Doing business as Saint Alphonsus Rehabilitation Services

  • Physical Therapy Clinic/Center
  • Meridian, ID
National Provider Identifier
1104045392
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC
Doing business as
Saint Alphonsus Rehabilitation Services
Practice address
3025 W Cherry LN
Suite D
Meridian, ID 83642
Phone
(208) 367-8593
Fax
(208) 367-8595
NPI assigned
Apr 25, 2007
Last updated
Sep 14, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Authorized official

Name
Marcie Harper
Title
Cfo
Phone
(208) 367-7192

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X ID
Physical Therapy Clinic/Center 261QP2000X ID Primary
Rehabilitation Clinic/Center 261QR0400X ID

Addresses

Primary practice location

3025 W Cherry LN
Suite D
Meridian, ID 83642

Mailing address

901 N Curtis Rd
#204
Boise, ID 83706-1338
Phone (208) 367-8950

Other names 1

  • SAINT ALPHONSUS REHABILITATION SERVICES Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030627000017 ID Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 3476462359 10 other NPIs on this enrollment
Practice locations: Meridian, ID; Eagle, ID; Boise, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104045392. Details of each certification follow.

  • CCN 136539 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 136539

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ST ALPHONSUS OUTPATIENT REHABILITATION SERVICES
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Feb 11, 2004
Last certification
Feb 11, 2004
Ownership / control type
VOLUNTARY NON PROFIT CHURCH
Facility address
3025 W Cherry Lane, Suite D
Meridian, ID 83642

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Pathology Services25 organizations share this tax ID, including this one
Part of
Pathology Services

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Saint Alphonsus Regional Rehabilitation Hospital, an Affiliate of EncoBoise, ID, CCN 133028 Hospital 5% Or Greater Indirect Ownership Interest (49%) Jan 29, 2018
Enhabit Home Health & HospiceBoise, ID, CCN 137006 Home health agency 5% Or Greater Direct Ownership Interest (50%) Jun 30, 2014
Enhabit Home Health & HospiceBoise, ID, CCN 131507 Hospice 5% Or Greater Direct Ownership Interest (50%) Jun 30, 2014

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789344000000",
    "number": "1104045392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N CURTIS RD",
            "address_2": "#204",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061338",
            "telephone_number": "208-367-8950",
            "fax_number": "208-367-6908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 W CHERRY LN",
            "address_2": "SUITE D",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-367-8593",
            "fax_number": "208-367-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC",
        "enumeration_date": "2007-04-25",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A",
        "authorized_official_last_name": "HARPER",
        "authorized_official_first_name": "MARCIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "208-367-7192"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "ID",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "ID",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "SAINT ALPHONSUS REHABILITATION SERVICES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SAINT ALPHONSUS REHABILITATION SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.