NPIMap

Organization Active NPI

St Lukes Regional Medical Center

Doing business as St Lukes Clinic - Caldwell Urology

  • Urology Physician
  • Caldwell, ID
National Provider Identifier
1952604563
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
03 Issued in ID
Legal business name
ST LUKES REGIONAL MEDICAL CENTER
Doing business as
St Lukes Clinic - Caldwell Urology
Practice address
1620 S Kimball Ave
Caldwell, ID 83605-4547
Phone
(208) 454-9181
NPI assigned
Dec 21, 2010
Last updated
Dec 21, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
ST LUKES REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 03 ID Primary

Addresses

Primary practice location

1620 S Kimball Ave
Caldwell, ID 83605-4547

Mailing address

1620 S Kimball Ave
Caldwell, ID 83605-4547
Phone (208) 454-9181

Other names 1

  • ST LUKES CLINIC - CALDWELL UROLOGY Doing business as

National Provider Directory

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

Other organizations with this tax ID 49

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

View all 49

Locations

1620 S Kimball Ave
Caldwell, ID 83605
Phone (208) 454-9181

NPI Registry JSON

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

{
    "created_epoch": "1292889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292889600000",
    "number": "1952604563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 S KIMBALL AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054547",
            "telephone_number": "208-454-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 S KIMBALL AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054547",
            "telephone_number": "208-454-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST LUKES REGIONAL MEDICAL CENTER",
        "enumeration_date": "2010-12-21",
        "last_updated": "2010-12-21",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "SYSTEM VP CFO",
        "authorized_official_telephone_number": "208-381-2520"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ID",
            "license": "03",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST LUKES CLINIC - CALDWELL UROLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.