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ST LUKES REGIONAL MED CTR DBA ST LUKES PEDIATRIC SURGERY OF IDAHO
NPI 1720204738
Surgery - Pediatric Surgery in Boise, ID

Active since April 18, 2007
100 E IDAHO ST, SUITE 300, BOISE, ID 83712(208) 345-5400(208) 345-5454 Get Directions Write a Review

NPPES record last updated: April 9, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About St Lukes Regional Med Ctr Dba St Lukes Pediatric Surgery Of Idaho NPPES

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

ST LUKES REGIONAL MED CTR DBA ST LUKES PEDIATRIC SURGERY OF IDAHO (NPI 1720204738) is a healthcare organization registered as a pediatric surgery in Boise, Idaho and active in the NPI registry since April 2007. The organization lists Carrie L Cowgill, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1720204738
Entity TypeOrganization
Primary Taxonomy2086S0120X
Legal Business NameST LUKES REGIONAL MED CTR DBA ST LUKES PEDIATRIC SURGERY OF IDAHO
Location Address100 E IDAHO ST, SUITE 300Boise, ID 83712-6223
Mailing Address100 E Idaho St, Suite 300Boise, ID 83712-6223 · (208) 345-5400 · Fax (208) 345-5454
Phone(208) 345-5400
Fax(208) 345-5454
Organization SubpartNo
Authorized OfficialCarrie L CowgillCredentialing Coordinator · (208) 381-4137
Enumeration DateApril 18, 2007
Last NPPES UpdateApril 9, 2008
✔ NPI 1720204738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
100 E IDAHO ST, Boise, ID 83712
Open in Google Maps ↗

Other Identifiers 1

Medicare PIN12509031

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

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

DR. NATHAN D MEEKER M.D.
Pediatrics (Pediatric Hematology-Oncology)
100 E IDAHO ST
BOISE, ID 83712
Ada County (208) 381-2782
MCKAY HERPEL PHARMD
Pharmacist (Oncology)
100 E IDAHO ST
BOISE, ID 83712
Ada County (208) 381-3108
DR. FREDERICK K EMGE MD
Pediatrics (Pediatric Cardiology)
100 E IDAHO ST, SUITE 200
BOISE, ID 83712
Ada County (208) 381-7384
DAN S ZUCKERMAN MD
Internal Medicine (Hematology & Oncology)
100 E IDAHO ST
BOISE, ID 83712
Ada County (208) 381-2711
MISTY NEISEN
Physician Assistant
100 E IDAHO ST
BOISE, ID 83712
Ada County (208) 381-2711
AMY MERCER RD
Dietitian, Registered
100 E IDAHO ST
BOISE, ID 83712
Ada County (208) 381-4011
DAVID B BETTIS MD
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
100 E IDAHO ST, STE 201
BOISE, ID 83712
Ada County (208) 381-5180
VIVIANA BAEZA NUNEZ
Massage Therapist
100 E IDAHO ST
BOISE, ID 83712
Ada County (208) 706-5287

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 Med Ctr Dba St Lukes Pediatric Surgery Of Idaho's NPI number?

The NPI number for St Lukes Regional Med Ctr Dba St Lukes Pediatric Surgery Of Idaho is 1720204738. It was assigned to this organization in the NPPES registry on April 18, 2007.

Where is St Lukes Regional Med Ctr Dba St Lukes Pediatric Surgery Of Idaho located?

St Lukes Regional Med Ctr Dba St Lukes Pediatric Surgery Of Idaho is located at 100 E Idaho St Suite 300, Boise, ID 83712. The listed phone number is (208) 345-5400.

What is St Lukes Regional Med Ctr Dba St Lukes Pediatric Surgery Of Idaho's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

When was this NPI record last updated?

The NPPES record for St Lukes Regional Med Ctr Dba St Lukes Pediatric Surgery Of Idaho was last updated on April 9, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.