St Lukes Regional Medical Center

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

03 Issued in ID

Legal business name

ST LUKES REGIONAL MEDICAL CENTER

Practice address

3399 E Louise Dr
Ste 400
Meridian, ID 83642-5047

Phone

(208) 364-3000

Fax

(208) 364-3191

NPI assigned

Dec 14, 2011

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, CFO

Title

System VP Cfo

Phone

(208) 381-2520

Specialties & licenses 2

Addresses

Other names 1

• ST LUKES CLINIC - GENERAL SURGERY Doing business as

Part of

Richard H Lane MD

Locations

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323820800000",
    "number": "1568731925",
    "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": "3399 E LOUISE DR",
            "address_2": "STE 400",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425047",
            "telephone_number": "208-364-3000",
            "fax_number": "208-364-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST LUKES REGIONAL MEDICAL CENTER",
        "enumeration_date": "2011-12-14",
        "last_updated": "2011-12-14",
        "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": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "ID",
            "license": "03",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "ID",
            "license": "03",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST LUKES CLINIC - GENERAL SURGERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• St Lukes Regional Medical Center
• St Lukes Regional Medical Center
• St Lukes Regional Medical Center
• St Lukes Regional Medical Center
• St Lukes Regional Medical Center
• St. Alphonsus Physician Services Inc
• St. Fillan'S, LLC
• Shawn Stadlbauer, DC
• Alexis Staeb, LMSW, CCLS, CFLE
• James Porter Stagg, DO

• Surgery Physician in Meridian, ID
• Providers in Meridian, ID by specialty
• Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.