Active NPI
St Luke's Regional Medical Center
Doing business as St Lukes Mountain States Urology
- Urology Physician
- Meridian, ID
National Provider Identifier
1780793596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 03
- Legal business name
- ST LUKE'S REGIONAL MEDICAL CENTER
- Doing business as
- St Lukes Mountain States Urology
- Practice address
- 520 S Eagle Rd
Ste 3112
Meridian, ID 83642-6351 - Phone
- (208) 706-5800
- NPI assigned
- Aug 29, 2006
- Last updated
- Sep 30, 2016
- Organization subpart
- Yes
- Parent organization
- ST LUKE'S REGIONAL MEDICAL CENTER
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 03 | ID | Primary |
| Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician | 2088F0040X | 03 | ID | |
| Pediatric Urology Physician | 2088P0231X | 03 | ID |
Addresses
Primary practice location
520 S Eagle Rd
Ste 3112
Meridian, ID 83642-6351
Mailing address
PO Box 640
Boise, ID 83701-0640
Phone (208) 381-2222
Other names 1
- St Lukes Mountain States Urology
National Provider Directory
National Provider Directory- Part of
- St Lukes Regional Med Ctr
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1475193600000",
"number": "1780793596",
"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": "520 S EAGLE RD",
"address_2": "STE 3112",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836426351",
"telephone_number": "208-706-5800"
}
],
"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": "2006-08-29",
"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": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "ID",
"license": "03",
"primary": true
},
{
"code": "2088F0040X",
"taxonomy_group": "",
"desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
"state": "ID",
"license": "03",
"primary": false
},
{
"code": "2088P0231X",
"taxonomy_group": "",
"desc": "Urology, Pediatric Urology",
"state": "ID",
"license": "03",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "St Lukes Mountain States Urology",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Meridian, ID
- St Luke's Elks Childrens Rehabilitation
- St Luke's Meridian Inpt Pharmacy
- St Luke's Regional Medical Center (St Luke's Clinic - St Luke's Family Health)
- St Luke's Regional Medical Center (St Lukes Home Care)
- St Luke's Regional Medical Center (St Luke's Hospice)
- St Luke's Regional Medical Center (St Luke's Boise Orthopedic Clinic)
- St Luke's Regional Medical Center (St Luke's Family Medicine)
- St Lukes Clinic - Treasure Valley LLC (St Luke's Lifestyles Medicine)
- St Lukes Family Health, LLC
- St Lukes Regional Medical Center (St Lukes Home Infusion)
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.