ST LUKES REGIONAL MEDICAL CENTER NPI 1003295452

NPI Information

NPI: 1003295452
Provider Name: ST LUKES REGIONAL MEDICAL CENTER

Doing Business As: ST LUKE'S HUMPHREYS DIABETES CENTER

Classification: Registered Nurse - 163WD0400X
Entity Type: Organization

Specialization: Diabetes Educator

Address:
1226 W RIVER ST
BOISE, ID
ZIP 83702
Phone: (208) 331-1155
Get Directions

ST LUKES REGIONAL MEDICAL CENTER is a diabetes educator registered nurse in Boise, ID. ST LUKES REGIONAL MEDICAL CENTER NPI is 1003295452. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As St Luke's Humphreys Diabetes Center.

The provider's business location address is:

1226 W RIVER ST
BOISE, ID
ZIP 83702-049
Phone: (208) 331-1155

The provider's authorized official is Jeff Taylor .
The authorized official title is Sr Vice President And Cfo and has the following contact phone number (208) 381-2520.

The enumeration date for this NPI number is 5/19/2015 and was last updated on 6/22/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	133V00000X	Dietitian, Registered		03	IDAHO	No
2	163WD0400X	Registered Nurse	Diabetes Educator	03	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1003295452	MEDICAID	IDAHO
2	20007319	MEDICARE PIN	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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