NPIMap

Organization Active NPI

St Lukes McCall, LTD

Doing business as St Lukes McCall Clinics

  • Family Medicine Physician
  • McCall, ID
National Provider Identifier
1336457738
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST LUKES MCCALL, LTD
Doing business as
St Lukes McCall Clinics
Practice address
209 Forest St
McCall, ID 83638-5256
Phone
(208) 634-2221
NPI assigned
Sep 20, 2010
Last updated
Jun 22, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
ST LUKES MCCALL, LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Authorized official

Name
Jeff Taylor, CFO
Title
System VP, Cfo
Phone
(208) 381-2520

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X ID
Registered Dietitian 133V00000X ID
Acupuncturist 171100000X ID
Family Medicine Physician 207Q00000X ID Primary
Surgery Physician 208600000X ID
Massage Therapist 225700000X ID

Addresses

Primary practice location

209 Forest St
McCall, ID 83638-5256

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 634-2221

Other names 1

  • ST LUKES MCCALL CLINICS Doing business as

National Provider Directory

National Provider Directory
Part of
St Lukes McCall LTD

Locations

200 W Forest St
McCall, ID 83638
Phone (208) 630-2470

2550 Addison Ave E
Ste Abf
Twin Falls, ID 83301

Practitioners & affiliated clinicians

Practitioners 38

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.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1336457738",
    "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": "208-634-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 FOREST ST",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836385256",
            "telephone_number": "208-634-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES MCCALL, LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST LUKES MCCALL, LTD",
        "enumeration_date": "2010-09-20",
        "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",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST LUKES MCCALL CLINICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McCall, ID

Sources for this page

  • 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.