NPIMap

St Lukes Magic Valley Regional Medical Center LTD

Organization Active NPI Psychiatric Hospital Unit · Twin Falls, ID

NPI 1164469870 · NPPES record last updated Apr 23, 2026

Key facts

NPI
1164469870
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric Hospital Unit 273R00000X
Legal business name
ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTD
Practice address
228 Shoup Ave W
Twin Falls, ID 83301-5022
Phone
(208) 734-6760
NPI assigned
Jun 1, 2006
Organization subpart
Yes
Parent organization (as reported)
ST LUKES HEALTH SYSTEM LTD

Authorized official

Name
Kathryn Fowler
Title
Senior VP, Cfo
Phone
(208) 381-8717

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 5

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

Other NPIs with the same Medicare PAC ID 5

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

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 19

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ID

Hospital certification: CCN 13S002

Legal name
ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTD
Doing business as
ST LUKES CANYON VIEW BEHAVIORAL HEALTH SERVICES
Organization structure
Corporation · Non-profit
Incorporated
Mar 13, 2006 in ID
Enrollment address
228 Shoup Ave W
Twin Falls, ID 83301-5022
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

All disclosed owners & managing parties 22

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Durmot Mark Durcan
Individual 		Corporate Director
At Large, Board Member		 Oct 1, 2018
Lisa Grow
Individual 		Corporate Director
At-Large, Board Member		 Oct 1, 2018
Emily Baker
Individual 		Corporate Director
At Large, Board Member		 Nov 1, 2021
Allan Korn
Individual 		Corporate Director
At-Large, Board Member		 Oct 1, 2018
Robert Lokken
Individual 		Corporate Director
At-Large, Board Member		 Oct 1, 2018
Andrew Scoggin
Individual 		Corporate Director
At-Large, Board Member		 Oct 1, 2018
Richard Raimondi
Individual 		Corporate Director
At-Large, Chairman		 Oct 1, 2018
Lucie a Dimaggio
Individual 		Corporate Director
At-Large, Board Member		 Oct 1, 2018
Daniel Krahn
Individual 		Corporate Director
At-Large, Board Member		 Oct 1, 2018
St Lukes Health System LTD
Organization · Boise, ID
For-profit 		5% Or Greater Indirect Ownership Interest Dec 4, 2007 100%
Jon Miller
Individual 		Corporate Director
At-Large, Board Member		 Oct 1, 2018
Jared Grant
Individual 		Corporate Officer
System Controller & Treasurer		 Jan 19, 2023
W-2 Managing Employee
System Controller & Treasurer		 Jan 19, 2023
St Lukes Magic Valley Regional Medical Center LTD
Organization · Twin Falls, ID
Non-profit 		5% Or Greater Direct Ownership Interest Dec 4, 2007 100%
Karen Vauk
Individual 		Corporate Director
At-Large, Board Member		 Oct 1, 2018
Jacob Reid
Individual 		Corporate Officer
PFM Administrator		 Sep 1, 2023
W-2 Managing Employee
PFM Administrator		 Sep 1, 2023
Kathryn Fowler
Individual 		Corporate Officer
Sr VP & Cfo		 Feb 1, 2021
Corporate Director
Sr VP & Cfo		 Feb 1, 2021
W-2 Managing Employee
Sr VP & Cfo		 Feb 1, 2021
Rosa Davila
Individual 		Corporate Director
At Large, Board Member		 Sep 1, 2021
William Whitacre
Individual 		Corporate Director
At-Large, Board Member		 Oct 1, 2018
Christopher Roth
Individual 		Corporate Officer
President & Ceo		 Oct 1, 2015
Corporate Director
President & Ceo		 Oct 1, 2015
W-2 Managing Employee
President & Ceo		 Jan 31, 2020
Robert Mueller
Individual 		Corporate Officer
VP Revenue Cycle		 Oct 1, 2015
Corporate Director
VP Revenue Cycle		 Oct 1, 2015
W-2 Managing Employee
VP Revenue Cycle		 Oct 1, 2015
Thomas K Corrick
Individual 		Corporate Director
At-Large, Board Member		 Oct 1, 2018
Brigette Bilyeu
Individual 		Corporate Director
At-Large, Board Member		 Oct 1, 2018

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
St Luke'S Inpatient Rehabilitation Unit
Twin Falls, ID · CCN 13T002		 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Aug 27, 2007
Aug 27, 2007
St Lukes Jerome
Jerome, ID · CCN 131310		 Hospital 5% Or Greater Direct Ownership Interest Oct 1, 2013
St Lukes Jerome Swing Beds
Jerome, ID · CCN 13Z310		 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Oct 1, 2013
Oct 1, 2013
St Lukes Clinic Jerome Family Medicine
Jerome, ID · CCN 133992		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2011

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070716000195 ID Part a Provider - Hospital 4880606326 Practice locations: Twin Falls, ID

National Provider Directory

Part of
St Luke'S Children'S

Locations

115 5th Ave W
Jerome, ID 83338
Phone (208) 324-8831

801 Pole Line Rd W
Twin Falls, ID 83301
Phone (208) 814-1000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Yes
Psychiatric Hospital 283Q00000X

Addresses

Primary practice location

228 Shoup Ave W
Twin Falls, ID 83301-5022

Mailing address

PO Box 2777
Boise, ID 83701-2777
Phone (208) 706-5000

Other identifiers

IdentifierTypeStateIssuer
100505262OtherIDNEVADA MEDICAID INPT PROV

Other names

  • ST LUKE'S CANYON VIEW BEHAVIORAL HEALTH SERVICES Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Other providers in Twin Falls, ID

All providers in Twin Falls, ID · Psychiatric Hospital Unit in Idaho

Sources for this page

Verify at the official NPI Registry.