ST LUKES RHC - TRINITY MOUNTAIN
NPI 1417297821
Clinic/Center - Rural Health in Mountain Home, ID
NPI Status: Active since February 21, 2013
Contact Information
465 MCKENNA DR
MOUNTAIN HOME, ID
ZIP 83647
Phone: (208) 587-9703
- Organization
- Clinic/Center
- Rural Health
- Accepts Insurance
- CLIA Number: 13D0922939
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-09-2026
About ST LUKES RHC - TRINITY MOUNTAIN
This page provides the complete NPI Profile along with additional information for St Lukes Rhc - Trinity Mountain, a primary care provider established in Mountain Home, Idaho operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1417297821 assigned on February 2013. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 3 years ago. St Lukes Rhc - Trinity Mountain operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as St Lukes Rhc - Trinity Mountain. The authorized official of this NPI record is Kathryn Fowler (Senior Vp, Cfo)
- NPI
- 1417297821
- Provider Legal Name
- ST LUKES CLINIC-TREASURE VALLEY LLC
- Other Organization Name
- ST LUKES RHC - TRINITY MOUNTAIN
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 465 MCKENNA DR MOUNTAIN HOME, ID 83647
- Location Phone
- (208) 587-9703
- Mailing Address
- PO BOX 640 BOISE, ID 83701
- Mailing Phone
- (208) 381-2222
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 02-21-2013
- Last Update Date
- 12-08-2022
- Code Navigator
A primary care provider (PCP) like St Lukes Rhc - Trinity Mountain sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Rural Health
- Taxonomy Code
- 261QR1300X
- Type
- Ambulatory Health Care Facilities
- License State
- ID
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | (ID) |
| 2 | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | (ID) |
| 3 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | (ID) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Moda Health Affinity Bronze 7750 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Moda Health Oregon Standard Bronze Affinity - EPO
- Moda Health Oregon Standard Gold Affinity - EPO
- Moda Health Oregon Standard Silver Affinity - EPO
- Connect Bronze Expanded Standard - PPO
- Connect Bronze HDHP - PPO
- Connect Catastrophic - PPO
- Connect Gold - PPO
- Connect Gold Standard - PPO
- Connect Silver - PPO
- Connect Silver Standard - PPO
- High Plains Bronze HDHP - PPO
- High Plains Bronze Standard Expanded - PPO
- High Plains Gold - PPO
- High Plains Gold HDHP - PPO
- High Plains Gold Standard - PPO
- High Plains Silver - PPO
- High Plains Silver Standard - PPO
- Plus Bronze Expanded - PPO
- Plus Bronze Standard Expanded - PPO
- Plus Gold - PPO
- Plus Gold Standard - PPO
- Plus Silver Standard - PPO
- ACCESS BRONZE - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1369110 | OTHER (01) | ID | MEDICARE / MULTI SPECIALTY CLINIC |
| 133999 | OTHER (01) | ID | MEDICARE / RHC |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 13D0922939
- Facility Type
- Physician Office
- Certificate Effective Date
- December 10, 2024
- Certificate Expiration Date
- December 09, 2026
- Laboratory Director
- JUSTIN SMITH
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to St Lukes Rhc - Trinity Mountain in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
Reviews for ST LUKES RHC - TRINITY MOUNTAIN
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 1 | 7 | 2 | 9 | 7 | 8 | 2 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 2 | 7 | 4 | 9 | 14 | 8 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 2 + 7 + 4 + 9 + 1 + 4 + 8 + 4 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1417297821 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 7 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1558341594 | DR. DENNIS DAN CROSSLEY M.D. Individual | Family Medicine | 465 MCKENNA DR MOUNTAIN HOME, ID 83647 (208) 587-9703 |
| 1508846353 | DR. KARL H. OLSON M.D. Individual | Family Medicine | 465 MCKENNA DR MOUNTAIN HOME, ID 83647 (208) 587-9703 |
| 1831179696 | ELMORE MEDICAL CENTER HOSPITAL DISTRICT Organization | Family Medicine | 465 MCKENNA DR MOUNTAIN HOME, ID 83647 (208) 587-9703 |
| 1780752469 | TIMOTHY JAMES MUHONEN MD Individual | Family Medicine | 465 MCKENNA DR MOUNTAIN HOME, ID 83647 (208) 587-9703 |
| 1003546276 | MS. MALINDA PAIGE WESTENDORF Individual | Physician Assistant | 465 MCKENNA DR MOUNTAIN HOME, ID 83647 (208) 587-9703 |
| 1871092189 | JOSEPH WELLS HOSKIN PA-C Individual | Physician Assistant | 465 MCKENNA DR MOUNTAIN HOME, ID 83647 (208) 587-9703 |
| 1962961359 | DR. KRISTIN ANNE HILDEBRANDT MD Individual | Family Medicine | 465 MCKENNA DR MOUNTAIN HOME, ID 83647 (208) 587-9703 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417297821, enumerated in the NPI registry as an "organization" on February 21, 2013
The provider is located at 465 Mckenna Dr Mountain Home, Id 83647 and the phone number is (208) 587-9703
This medical organization specializes in Clinic/Center with taxonomy code 261QR1300X with a focus in Rural Health
The provider might be accepting Accepts: Moda Health Plan, Inc., Mountain Health CO-OP,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 13D0922939 for a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on February 21, 2013. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.