St. Luke'S Treasure Valley Pediatrics

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ST. LUKE'S TREASURE VALLEY PEDIATRICS

Practice address

450 W State St Ste 100
Eagle, ID 83616-7055

Phone

(208) 939-1035

Fax

(208) 939-8970

NPI assigned

Jul 31, 2015

Organization subpart

No

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

Authorized official

Name

Alisha Lauren Miller

Title

Family Nurse Practitioner

Phone

(208) 939-1035

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

St Luke'S Lifestyles Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• St Lukes Clinic - Treasure Valley LLC

  • Public Health & General Preventive Medicine Physician
  • Meridian, ID
  • NPI 1861982456
  NPD tax ID

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438300800000",
    "number": "1396121349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 W STATE ST STE 100",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167055",
            "telephone_number": "208-939-1035",
            "fax_number": "208-939-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W STATE ST STE 100",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167055",
            "telephone_number": "208-939-1035",
            "fax_number": "208-939-8970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S TREASURE VALLEY PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-31",
        "last_updated": "2015-07-31",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ALISHA",
        "authorized_official_middle_name": "LAUREN",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "208-939-1035"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Spencer, PT
• Dorothy Ann Spenner, LCPC, LMFT
• Anna Sprinkel
• Sprouted Therapy
• St Lukes Regional Medical Center
• Allison Stafford
• Lukas Stashik
• State of Mind Counseling and Wellness Center
• Kathryn L Stednitz, DPT
• Jazmyne Stephens

• Primary Care Clinic/Center in Eagle, ID
• Providers in Eagle, ID by specialty
• Primary Care Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.