NPIMap

Organization Active NPI

St. Luke's Elks Childrens Rehab

  • Children's Rehabilitation Hospital
  • Boise, ID
National Provider Identifier
1548697006
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Rehabilitation HospitalTaxonomy code 283XC2000X
License
SLP-2340 Issued in ID
Legal business name
ST. LUKE'S ELKS CHILDRENS REHAB
Practice address
405 W Myrtle St
Boise, ID 83702-7658
Phone
(208) 489-5880
NPI assigned
Sep 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Authorized official

Name
Brent Wilson
Title
Compliance and Risk Management
Phone
(208) 489-4761

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Rehabilitation Hospital 283XC2000X SLP-2340 ID Primary

Addresses

Primary practice location

405 W Myrtle St
Boise, ID 83702-7658

Mailing address

405 W Myrtle St
Boise, ID 83702-7658

National Provider Directory

National Provider Directory
Tax ID family
St Luke's Elks Childrens Rehab2 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.

NPI Registry JSON

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380499200000",
    "number": "1548697006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W MYRTLE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837027658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W MYRTLE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837027658",
            "telephone_number": "208-489-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S ELKS CHILDRENS REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-30",
        "last_updated": "2013-09-30",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "COMPLIANCE AND RISK MANAGEMENT",
        "authorized_official_telephone_number": "208-489-4761"
    },
    "taxonomies": [
        {
            "code": "283XC2000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital, Children",
            "state": "ID",
            "license": "SLP-2340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.