# ST LUKE'S CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTD
- **Other names:** St Lukes Clinic - Magic Valley/Jerome, St Lukes Jerome RHC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790718229
- **Legal business name:** ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTD
- **Authorized official:** KATHRYN FOWLER (SENIOR VP, CFO)
- **Authorized official phone:** (208) 381-8717

## Contact information

- **Practice address:** 775 POLE LINE RD W, TWIN FALLS, ID 83301-5814
- **Practice address phone:** (208) 814-1000
- **Mailing address:** PO BOX 640, BOISE, ID 83701-0640
- **Mailing address phone:** (208) 706-5000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RN0300X | Nephrology Physician | — | NULL | — |
| 207RN0300X | Nephrology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2083X0100X | Occupational Medicine Physician | — | NULL | — |
| 2083X0100X | Occupational Medicine Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 07/08/2006
- **Last updated:** 04/23/2026