NPI age
15 years
Enumerated 2010-12-21
● Active Type 2 · Organization
Subpart
St Luke'S Regional Medical Center
St Luke'S Regional Medical Center is 1 of 1691 family medicine organizations in Idaho.
Primary specialty
Family Medicine
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Taylor
System Vp Cfo
Last NPPES update
2010-12-21
Source: monthly bulk 2026-05
How this organization compares
Across 1691 active family medicine providers in Idaho.
NPI age
15 years
↓ 2 yr below median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 31% of peers with subspecialties
NPI lifetime · 2010 → 2026
2010-12Enumerated in NPPES
2010
2026
Where they practice
Primary practice location
3090 E Gentry Way, Ste 200
Meridian, ID 836423501
Mailing address
2083 E Hospitality Ln
Boise, ID 837166603
Authorized official
Jeff Taylor
System Vp Cfo
📞 2083812520
Individual providers at this organization
5 individual providers on file at this primary practice address.
- Brenda Adams, MD Family Medicine NPI 1205887288
- Glen Bailey, MPT Physical Therapist NPI 1114094737
- William Crump, MD Family Medicine NPI 1740232529
- D Hall, DO Family Medicine NPI 1780671347
- Tristan Thorne, DPT Physical Therapist NPI 1447286125
Specialties
-
Family Medicine PrimaryFamily 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...
-
Nurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
St Luke's Clinic - St Luke's Family Health
Practice context
Multi-provider organization. 5 individual providers on file at this primary address.
Subpart of St Luke'S Regional Medical Center.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.