NPIMap

Organization Active NPI

St Luke'S Regional Medical Center

  • Cardiovascular Disease Physician
  • Boise, ID
National Provider Identifier
1659699841
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
03 Issued in ID
Legal business name
ST LUKE'S REGIONAL MEDICAL CENTER
Practice address
333 N 1St St
Ste 280
Boise, ID 83702-6100
Phone
(208) 345-6545
NPI assigned
May 12, 2010
Organization subpart
Yes
Parent organization
ST LUKE'S REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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

Authorized official

Name
Jeff Taylor
Title
Sr VP/Cfo
Phone
(208) 381-2520

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X 03 ID Primary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X 03 ID
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X 03 ID

Addresses

Primary practice location

333 N 1St St
Ste 280
Boise, ID 83702-6100

Mailing address

PO Box 640
Boise, ID 83701-0640
Phone (208) 381-2222

Other names 1

  • St Luke's Cardiothoracic & Vascular Associates Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2176548St Luke'S Surgery Center333 1St St Ste 110, Boise, ID 83702Certificate of waiverDec 16, 2027

National Provider Directory

National Provider Directory
Part of
Richard H Lane MD

Locations

977 S Progress Ave
Meridian, ID 83642
Phone (208) 345-6545

NPI Registry JSON

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475193600000",
    "number": "1659699841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837010640",
            "telephone_number": "208-381-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N 1ST ST",
            "address_2": "STE 280",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026100",
            "telephone_number": "208-345-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKE'S REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST LUKE'S REGIONAL MEDICAL CENTER",
        "enumeration_date": "2010-05-12",
        "last_updated": "2016-09-30",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "SR VP/CFO",
        "authorized_official_telephone_number": "208-381-2520"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ID",
            "license": "03",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "ID",
            "license": "03",
            "primary": false
        },
        {
            "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 Luke's Cardiothoracic & Vascular Associates",
            "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 Sep 30, 2016; 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.