NPIMap

Organization Active NPI

St Lukes Magic Valley Regional Medical Center LTD

  • Rehabilitation Hospital Unit
  • Twin Falls, ID
National Provider Identifier
1285833343
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
14 Issued in ID
Legal business name
ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTD
Practice address
775 Pole Line Rd W Ste 307
Twin Falls, ID 83301-5823
Phone
(208) 814-3725
NPI assigned
Jul 17, 2007
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 14 ID Primary

Addresses

Primary practice location

775 Pole Line Rd W Ste 307
Twin Falls, ID 83301-5823

Mailing address

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

Other names 1

  • St Lukes Inpatient Rehabilitation Unit Other name

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
O20070822000770 ID Part A Provider - Hospital 4880606326 1 other NPI on this enrollment
Practice locations: Twin Falls, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285833343. Details of each certification follow.

Hospital certification: CCN 13T002

Legal name
ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTD
Doing business as
ST LUKE'S INPATIENT REHABILITATION UNIT
Organization structure
CorporationNon-profit
Incorporated
Mar 13, 2006 in ID
Enrollment address
775 Pole Line Rd W
Ste 307
Twin Falls, ID 83301-5823
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation 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).

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
St. Luke's Magic Valley Regional Medical CenterCCN 13T002 · All quality measures
Ownership
Non-profit
Certified
Oct 1, 2007

National Provider Directory

National Provider Directory
Tax ID family
SLMV Medical Center6 organizations share this tax ID, including this one
Part of
St Luke's Children's

Other organizations with this tax ID 5

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

Locations

775 Pole Line Rd W
Ste 307
Twin Falls, ID 83301
Phone (208) 814-2495

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Laura a McGeorge Individual Corporate DirectorBoard Member Jul 1, 2024
David Snelson Individual Corporate DirectorBoard Member Oct 1, 2024
Lisa Grow Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Emily Baker Individual Corporate DirectorBoard Member Nov 1, 2021
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
Daniel Krahn Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
St Lukes Health System LTD Organization, Boise, ID Non-profit 5% Or Greater Indirect Ownership Interest Aug 27, 2007 100%
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 Aug 27, 2007 100%
Operational/Managerial Control Aug 27, 2007
Jacob Reid Individual Corporate OfficerPFM Administrator Sep 1, 2023
W-2 Managing EmployeePFM Administrator Sep 1, 2023
Kathryn Fowler Individual Corporate DirectorVP Operational Finance Feb 1, 2021
W-2 Managing EmployeeVP Operational Finance Feb 1, 2021
Rosa Davila Individual Corporate DirectorBoard Member Sep 1, 2021
William Gilbert Individual Corporate DirectorBoard Member Nov 1, 2022
William Whitacre Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Christopher Roth Individual Corporate OfficerPresident & Ceo Jan 31, 2020
Corporate DirectorPresident & Ceo Jan 31, 2020
W-2 Managing EmployeePresident & Ceo Oct 1, 2015
Jill Twedt Individual Corporate DirectorBoard Member Nov 1, 2022
Thomas K Corrick Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
William Ystueta Jr Individual Corporate DirectorBoard Member Oct 1, 2023

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 Lukes Canyon View Behavioral Health ServicesTwin Falls, ID, CCN 13S002 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 4, 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

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776902400000",
    "number": "1285833343",
    "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": "775 POLE LINE RD W STE 307",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015823",
            "telephone_number": "208-814-3725"
        }
    ],
    "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": "2007-07-17",
        "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": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "ID",
            "license": "14",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Lukes Inpatient Rehabilitation Unit",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "St Lukes Inpatient Rehabilitation Unit",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.