St Luke'S Clinic LLC
NPI 1790718229 · Family Medicine Physician · Twin Falls, ID
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1790718229
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- St Lukes Magic Valley Regional Medical Center Ltd
- Organization subpart
- Yes
- Authorized official
- Kathryn Fowler, Senior Vp, Cfo(208) 381-8717
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
- Rural Health Clinic/Center261QR1300X
Ambulatory Health Care Facilities
- Occupational Medicine Physician2083X0100X
Allopathic & Osteopathic Physicians
- Pediatrics Physician208000000X
Allopathic & Osteopathic Physicians
- Cardiovascular Disease Physician207RC0000X
Allopathic & Osteopathic Physicians
- Surgery Physician208600000X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
Mailing address
Other names (DBA / former)
- Doing business as
- St Lukes Clinic - Magic Valley/Jerome
- Doing business as
- St Lukes Jerome Rhc
Additional practice locations (1)
- 132 5th Ave W Ste 1/2Jerome, ID 83338-1825Phone: (208) 814-9800
Registry dates
- Enumerated
- 2006-07-08
- Last updated
- 2026-04-23
- Certified
- 2026-04-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.