NPIMap

Organization Active NPI

St Lukes Clinic - Treasure Valley LLC

Doing business as St Luke's Lifestyles Medicine

  • Public Health & General Preventive Medicine Physician
  • Meridian, ID
National Provider Identifier
1861982456
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
Legal business name
ST LUKES CLINIC - TREASURE VALLEY LLC
Doing business as
St Luke's Lifestyles Medicine
Practice address
5155 S Howry Lane
Meridian, ID 83642
Phone
(208) 381-2222
NPI assigned
May 18, 2018
Last updated
May 18, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. LUKE'S HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 18, 2018

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X Primary

Addresses

Primary practice location

5155 S Howry Lane
Meridian, ID 83642

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222

Other names 1

  • St Luke's Lifestyles Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Luke's Lifestyles Medicine2 organizations share this tax ID, including this one
Part of
St Luke's Children's

Other organizations with this tax ID 1

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

Ownership & related parties

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.

NPI Registry JSON

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526601600000",
    "number": "1861982456",
    "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": "5155 S HOWRY LANE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-381-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES CLINIC - TREASURE VALLEY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. LUKE'S HEALTH SYSTEM",
        "enumeration_date": "2018-05-18",
        "last_updated": "2018-05-18",
        "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": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Luke's Lifestyles Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; 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.