NPIMap

Organization Active NPI

St Lukes Regional Medical Center

  • Medical Specialty Clinic/Center
  • Meridian, ID
National Provider Identifier
1316980345
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
ST LUKES REGIONAL MEDICAL CENTER
Practice address
520 S Eagle Rd
Suite 3102
Meridian, ID 83642-6351
Phone
(208) 706-5100
Fax
(208) 706-5169
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Carrie Lynne Cowgill
Title
Credentialing Coordinator
Phone
(208) 381-4137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

520 S Eagle Rd
Suite 3102
Meridian, ID 83642-6351

Mailing address

PO Box 550
Boise, ID 83701-0550
Phone (208) 706-5100

Other names 1

  • ST LUKES INTERNAL MEDICINE Doing business as

National Provider Directory

National Provider Directory

Locations

125 E Idaho St
Ste 3
Boise, ID 83712

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316980345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837010550",
            "telephone_number": "208-706-5100",
            "fax_number": "208-706-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S EAGLE RD",
            "address_2": "SUITE 3102",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426351",
            "telephone_number": "208-706-5100",
            "fax_number": "208-706-5169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COWGILL",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "208-381-4137"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST LUKES INTERNAL MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.