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ST LUKES CLINIC - CAPITAL CITY FAMILY MEDICINE
NPI 1053624759
Family Medicine in Boise, ID

Active since July 22, 2010CLIA 13D0521601 · Microscopy
1520 W STATE ST, STE 100, BOISE, ID 83702(208) 947-7700 Get Directions Write a Review

NPPES record last updated: July 22, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About St Lukes Clinic - Capital City Family Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST LUKES CLINIC - CAPITAL CITY FAMILY MEDICINE (NPI 1053624759) is a healthcare organization registered as a family medicine in Boise, Idaho and active in the NPI registry since July 2010. The organization holds a CLIA Microscopy certificate valid through October 31, 2027 and lists John Kee, Vp Physician Services, as its authorized official.

NPPES Registry Identity

NPI1053624759
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameST LUKES REGIONAL MEDICAL CENTER
Location Address1520 W STATE ST, STE 100Boise, ID 83702-4085
Mailing Address1520 W State St, Ste 100Boise, ID 83702-4085 · (208) 947-7700
Phone(208) 947-7700
Organization SubpartYes
Authorized OfficialJohn KeeVp Physician Services · (208) 381-5329
Enumeration DateJuly 22, 2010
✔ NPI 1053624759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in ID · 03
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedInternal MedicineTaxonomy 207R00000X · License 03 (ID)
Also ListedPediatricsTaxonomy 208000000X · License 03 (ID)
1520 W STATE ST, Boise, ID 83702
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Other Names 1

Doing Business AsSt Lukes Clinic - Capital City Family Medicine

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 13D0521601

St Luke's Clinic Capital City Family Medicine · Boise, ID
Active · expires Oct 31, 2027
CLIA Number13D0521601
Laboratory TypePhysician Office
Certificate Effective DateNovember 1, 2025
Certificate Expiration DateOctober 31, 2027
Laboratory DirectorWaj Nasser
Laboratory Phone(208) 367-6990
Laboratory LocationSt Luke's Clinic Capital City Family Medicine1520 W State St #100, Boise, ID 83702
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA ANNE BRIGGS PA-C
Physician Assistant (Medical)
1520 W STATE ST, SUITE 100
BOISE, ID 83702
Ada County (208) 947-7700
WAJEEH E NASSER MD
Family Medicine
1520 W STATE ST, STE 100
BOISE, ID 83702
Ada County (208) 947-7700
CATHERINE ELIZABETH DUKE P.T.
Physical Therapist
1520 W STATE ST, STE. 210
BOISE, ID 83702
Ada County (208) 336-8433
ADREEANNA KAYE SCRIVNER RN
Registered Nurse (Ambulatory Care)
1520 W STATE ST
BOISE, ID 83702
Ada County (208) 947-7700
WILLIAM L JONAKIN MD
Family Medicine
1520 W STATE ST, SUITE 100
BOISE, ID 83702
Ada County (208) 947-7700
COLLIN REID
Physical Therapist
1520 W STATE ST, SUITE 210
BOISE, ID 83702
Ada County (208) 336-8433
TARA S WHITAKER MD
Family Medicine
1520 W STATE ST, SUITE 100
BOISE, ID 83702
Ada County (208) 947-7700
KATHLEEN J DUFFY PA-C
Physician Assistant
1520 W STATE ST, STE 100
BOISE, ID 83702
Ada County (208) 947-7700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St Lukes Regional Medical Center's NPI number?

The NPI number for St Lukes Regional Medical Center is 1053624759. It was assigned to this organization in the NPPES registry on July 22, 2010. The provider is doing business as St Lukes Clinic - Capital City Family Medicine.

Where is St Lukes Regional Medical Center located?

St Lukes Regional Medical Center is located at 1520 W State St Ste 100, Boise, ID 83702. The listed phone number is (208) 947-7700.

What is St Lukes Regional Medical Center's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does St Lukes Regional Medical Center hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 13D0521601) is associated with this NPI, valid through October 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for St Lukes Regional Medical Center was last updated on July 22, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.