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Organization Active NPI

St Lukes Magic Valley Regional Medical Center LTD

Doing business as St Luke's Canyon View Behavioral Health Services

  • Psychiatric Hospital Unit
  • Twin Falls, ID
National Provider Identifier
1164469870
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTD
Doing business as
St Luke's Canyon View Behavioral Health Services
Practice address
228 Shoup Ave W
Twin Falls, ID 83301-5022
Phone
(208) 734-6760
NPI assigned
Jun 1, 2006
Last updated
Apr 23, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
ST LUKES HEALTH SYSTEM LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary
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 1

IdentifierTypeStateIssuer
100505262OtherIDNEVADA MEDICAID INPT PROV

Other names 1

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

Electronic endpoints 1

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

Medicare participation

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

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164469870. Details of each certification follow.

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
CorporationNon-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

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Part of
St Luke's Children's

Ownership & related parties

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 DirectorAt Large, Board Member Oct 1, 2018
Lisa Grow Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Emily Baker Individual Corporate DirectorAt Large, Board Member Nov 1, 2021
Allan Korn Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Robert Lokken Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Andrew Scoggin Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Richard Raimondi Individual Corporate DirectorAt-Large, Chairman Oct 1, 2018
Lucie a Dimaggio Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Daniel Krahn Individual Corporate DirectorAt-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 DirectorAt-Large, Board Member Oct 1, 2018
Jared Grant Individual Corporate OfficerSystem Controller & Treasurer Jan 19, 2023
W-2 Managing EmployeeSystem 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 DirectorAt-Large, Board Member Oct 1, 2018
Jacob Reid Individual Corporate OfficerPFM Administrator Sep 1, 2023
W-2 Managing EmployeePFM Administrator Sep 1, 2023
Kathryn Fowler Individual Corporate OfficerSr VP & Cfo Feb 1, 2021
Corporate DirectorSr VP & Cfo Feb 1, 2021
W-2 Managing EmployeeSr VP & Cfo Feb 1, 2021
Rosa Davila Individual Corporate DirectorAt Large, Board Member Sep 1, 2021
William Whitacre Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Christopher Roth Individual Corporate OfficerPresident & Ceo Oct 1, 2015
Corporate DirectorPresident & Ceo Oct 1, 2015
W-2 Managing EmployeePresident & Ceo Jan 31, 2020
Robert Mueller Individual Corporate OfficerVP Revenue Cycle Oct 1, 2015
Corporate DirectorVP Revenue Cycle Oct 1, 2015
W-2 Managing EmployeeVP Revenue Cycle Oct 1, 2015
Thomas K Corrick Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Brigette Bilyeu Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018

Owners & managing parties with NPI records 6

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

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 UnitTwin Falls, ID, CCN 13T002 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Aug 27, 2007
Aug 27, 2007
St Lukes JeromeJerome, ID, CCN 131310 Hospital 5% Or Greater Direct Ownership Interest Oct 1, 2013
St Lukes Jerome Swing BedsJerome, ID, CCN 13Z310 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Oct 1, 2013
Oct 1, 2013
St Lukes Clinic Jerome Family MedicineJerome, ID, CCN 133992 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2011

Owned or controlled facilities with NPI records 5

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

Facilities with the same owner 19

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

View all 19

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.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776902400000",
    "number": "1164469870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2777",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837012777",
            "telephone_number": "208-706-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 SHOUP AVE W",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015022",
            "telephone_number": "208-734-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST LUKES HEALTH SYSTEM LTD",
        "enumeration_date": "2006-06-01",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "SENIOR VP, CFO",
        "authorized_official_telephone_number": "208-381-8717"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA MEDICAID INPT PROV",
            "identifier": "100505262",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ST LUKE'S CANYON VIEW BEHAVIORAL HEALTH SERVICES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ST LUKE'S CANYON VIEW BEHAVIORAL HEALTH SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.