Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

St Lukes Regional Medical Center

Organization Family Medicine Physician · NPI 1053624759

St Lukes Regional Medical Center is a Family Medicine Physician in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2010.

Licensed in
ID
In the registry since
2010
Specialties on file
3
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Practice location Address checks out

1520 W State St Ste 100
Boise, ID 83702-4085
Phone: (208) 947-7700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 03 (ID)
Internal Medicine Physician Taxonomy 207R00000X · Licence 03 (ID)
Pediatrics Physician Taxonomy 208000000X · Licence 03 (ID)

Record details

NPI number1053624759
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSt Lukes Regional Medical Center
Authorized official John Kee — Vp Physician Services · (208) 381-5329
Other names St Lukes Clinic - Capital City Family Medicine
NPI enumeratedJuly 22, 2010
Last updated in NPPESJuly 22, 2010
Mailing address1520 W State St, Ste 100, Boise, ID 83702-4085

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