St Lukes Regional Medical Center

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

03 Issued in ID

Legal business name

ST LUKES REGIONAL MEDICAL CENTER

Doing business as

St Lukes Elmore Medical Center Physician Group

Practice address

895 N 6TH E
Mountain Home, ID 83647-2207

Phone

(208) 587-8401

Fax

(208) 587-8406

NPI assigned

Feb 21, 2013

Organization subpart

Yes

Parent organization

ST LUKES REGIONAL MEDICAL CENTERAs reported in NPPES

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

Authorized official

Name

Jeff Taylor

Title

System VP Cfo

Phone

(208) 381-2520

Specialties & licenses 2

Addresses

Other names 1

• St Lukes Elmore Medical Center Physician Group Doing business as

Part of

Richard H Lane MD

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1326388737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 N 6TH E",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836472207",
            "telephone_number": "208-587-8401",
            "fax_number": "208-587-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST LUKES REGIONAL MEDICAL CENTER",
        "enumeration_date": "2013-02-21",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "SYSTEM VP CFO",
        "authorized_official_telephone_number": "208-381-2520"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "03",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "ID",
            "license": "03",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Lukes Elmore Medical Center Physician Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Delmar Wallace Smith, P.A.
• Jolee A Smith, BSW
• Martin McKay Smith
• Spartan Dental Company, LLC
• St Lukes Clinic-Treasure Valley LLC
• St Lukes Regional Medical Center
• St Lukes Regional Medical Center
• St Lukes Regional Medical Center
• St Lukes Regional Medical Center
• Daren A Stafford, DPT

• Emergency Medicine Physician in Mountain Home, ID
• Providers in Mountain Home, ID by specialty
• Emergency Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.