NPIMap

Organization Active NPI

St Lukes Regional Medical Center

Doing business as St Lukes Medical Clinic @ HP

  • Family Medicine Physician
  • Boise, ID
National Provider Identifier
1639356173
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
03 Issued in ID
Legal business name
ST LUKES REGIONAL MEDICAL CENTER
Doing business as
St Lukes Medical Clinic @ HP
Practice address
11311 W Chinden Blvd
Boise, ID 83714-1021
Phone
(208) 381-4120
NPI assigned
Jan 28, 2008
Last updated
Jan 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Authorized official

Name
Shanna Richter
Title
Manager
Phone
(208) 381-4120

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 03 ID Primary

Addresses

Primary practice location

11311 W Chinden Blvd
Boise, ID 83714-1021

Mailing address

PO Box 550
Boise, ID 83701-0550
Phone (208) 381-4120

Other names 1

  • ST LUKES MEDICAL CLINIC @ HP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ted Thurman FNP50 organizations share this tax ID, including this one

Other organizations with this tax ID 49

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

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1639356173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837010550",
            "telephone_number": "208-381-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11311 W CHINDEN BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837141021",
            "telephone_number": "208-381-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "RICHTER",
        "authorized_official_first_name": "SHANNA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "208-381-4120"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "03",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST LUKES MEDICAL CLINIC @ HP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 28, 2008; 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.