NPI age
13 years
Enumerated 2013-02-21
● Active Type 2 · Organization
Subpart
St Lukes Clinic-Treasure Valley Llc
St Lukes Clinic-Treasure Valley Llc is 1 of 1691 family medicine organizations in Idaho.
Primary specialty
Family Medicine
Plus 3 secondary
Practice locations
2
1 secondary on file
Status
Active
No deactivations on record
Authorized official
Fowler
Senior Vp, Cfo
Last NPPES update
2026-04-23
Source: monthly bulk 2026-05
How this organization compares
Across 1691 active family medicine providers in Idaho.
NPI age
13 years
↓ 4 yr below median
Practice locations
2
1 secondary on file
Subspecialties
3
In the 31% of peers with subspecialties
NPI lifetime · 2013 → 2026
2013-02Enumerated in NPPES
2013
2026
Where they practice
Primary practice location
840 N 4th E
Mountain Home, ID 836472166
Mailing address
Po Box 640
Boise, ID 837010640
Additional practice locations
1 secondary location on file with NPPES.
Location 2
465 McKenna Dr
Mountain Home, ID 836472143
Authorized official
Kathryn Fowler
Senior Vp, Cfo
📞 2083818717
Individual providers at this organization
5 individual providers on file at this primary practice address.
- Dirk Baskett, PA-C Physician Assistant NPI 1841920220
- Melissa MacLean Nurse Practitioner NPI 1922707686
- Vernon Mullins, MSN, APRN, FNP-BC Nurse Practitioner NPI 1255168449
- Robin Nettleton, NP-C Nurse Practitioner NPI 1336784081
- Jason Oakes, FNP-C Nurse Practitioner NPI 1902751423
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...
-
Clinic/CenterDefinition to come...
-
Internal MedicineA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer,...
-
PediatricsA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 1369110 | MEDICARE / MULTI SPECIALTY CLINIC |
| 01 (ID) | 133999 | MEDICARE / RHC |
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
St Lukes RHC - Trinity Mountain
-
St Lukes Clinic - Trinity Mountain
Practice context
Multi-provider organization. 5 individual providers on file at this primary address. Plus 1 secondary practice location.
Subpart of St Lukes Regional Medical Center Ltd.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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