OrganizationActive
St. Luke'S Regional Medical Center
NPI 1396916417 · Adult Health Nurse Practitioner · Boise, ID
Provider details
- NPI number
- 1396916417
- Entity type
- Organization
- Primary specialty
- Adult Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Parent organization
- St. Luke'S Regional Medical Center
- Organization subpart
- Yes
- Authorized official
- Edwin Dahlberg, President & Ceo(208) 381-2222
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
300 E Jefferson St
Suite 101
Boise, ID 83712-6246
Phone: (208) 336-4141
Street-level locationGet directions
Mailing address
Po Box 110
Boise, ID 83701-0110
Other names (DBA / former)
- Doing business as
- St. Luke'S Idaho Cardiology Associates
Registry dates
- Enumerated
- 2008-03-17
- Last updated
- 2008-03-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.