NPIMap

Organization Active NPI

St Lukes Regional Medical Center

Doing business as St Lukes Elmore Medical Center

  • Critical Access Hospital
  • Mountain Home, ID
National Provider Identifier
1699013565
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
ST LUKES REGIONAL MEDICAL CENTER
Doing business as
St Lukes Elmore Medical Center
Practice address
895 N 6TH E
Mountain Home, ID 83647-2207
Phone
(208) 587-8401
NPI assigned
Jan 28, 2013
Last updated
Apr 23, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
ST LUKES HEALTH SYSTEM LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Authorized official

Name
Kathryn Fowler
Title
Senior VP, Cfo
Phone
(208) 381-8717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X ID Primary

Addresses

Primary practice location

895 N 6TH E
Mountain Home, ID 83647-2207

Mailing address

PO Box 2777
Boise, ID 83701-2777
Phone (208) 706-5000

Other names 1

  • ST LUKES ELMORE MEDICAL CENTER Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130411000094 ID Part A Provider - Critical Access Hospital 5799692604 1 other NPI on this enrollment
Practice locations: Mountain Home, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699013565. Details of each certification follow.

Hospital certification: CCN 131311

Legal name
ST LUKES REGIONAL MEDICAL CENTER
Doing business as
ST LUKES ELMORE MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Aug 1, 2000
Last certification
Feb 12, 2015
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 20, 1906 in ID
Enrollment address
895 N 6TH E
Mountain Home, ID 83647-2207
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
St Luke's Elmore Medical CenterCCN 131311 · All quality measures
Overall star rating
5 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
St Lukes Regional Med Ctr50 organizations share this tax ID, including this one
Part of
St Luke's Children's

Other organizations with this tax ID 49

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

View all 49

Ownership & related parties

All disclosed owners & managing parties 21

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Durmot Mark Durcan Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Lisa Grow Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Emily Baker Individual Corporate DirectorAt Large, Board Member Oct 1, 2021
Allan Korn Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Robert Lokken Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Andrew Scoggin Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Richard Raimondi Individual Corporate DirectorAt-Large, Chairman Oct 1, 2018
Lucie a Dimaggio Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Daniel Krahn Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
St Lukes Health System LTD Organization, Boise, ID Non-profit 5% Or Greater Direct Ownership Interest Apr 1, 2013 100%
Jon Miller Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Jared Grant Individual Corporate OfficerSystem Controller & Treasurer Jan 19, 2023
W-2 Managing EmployeeSystem Controller & Treasurer Jan 19, 2023
Karen Vauk Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Jacob Reid Individual Corporate OfficerPFM Administrator Sep 1, 2023
W-2 Managing EmployeePFM Administrator Sep 1, 2023
Kathryn Fowler Individual Corporate OfficerVP Operational Finance Feb 1, 2021
Corporate DirectorVP Operational Finance Feb 1, 2021
W-2 Managing EmployeeVP Operational Finance Feb 1, 2021
Rosa Davila Individual Corporate DirectorAt Large, Board Member Oct 1, 2021
William Whitacre Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Christopher Roth Individual Corporate OfficerPresident & Ceo Jan 31, 2020
Corporate DirectorPresident & Ceo Jan 31, 2020
W-2 Managing EmployeePresident & Ceo Oct 1, 2015
Robert Mueller Individual Corporate OfficerVP Revenue Cycle Apr 1, 2015
Corporate DirectorVP Revenue Cycle Apr 1, 2015
W-2 Managing EmployeeVP Revenue Cycle Apr 1, 2015
Thomas K Corrick Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018
Brigette Bilyeu Individual Corporate DirectorAt-Large, Board Member Oct 1, 2018

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St Lukes Rehabilitation Inpatient Acute Care UnitBoise, ID, CCN 13T006 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2014
St Lukes Clinic - Eastern Oregan Medical AssociatesBaker City, OR, CCN 383852 Rural health clinic 5% Or Greater Direct Ownership Interest Sep 1, 2016
St Lukes Clinic-Trinity Mountain MedicalMountain Home, ID, CCN 133999 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2016

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 19

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 19

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Affiliated clinicians 283

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 283

NPI Registry JSON

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776902400000",
    "number": "1699013565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2777",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837012777",
            "telephone_number": "208-706-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 N 6TH E",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836472207",
            "telephone_number": "208-587-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST LUKES HEALTH SYSTEM LTD",
        "enumeration_date": "2013-01-28",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "SENIOR VP, CFO",
        "authorized_official_telephone_number": "208-381-8717"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ST LUKES ELMORE MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ST LUKES ELMORE MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mountain Home, ID

Sources for this page

Verify at the official NPI Registry.