Individual provider Active NPI

Amanda D Horricks, PA-C

  • Medical Physician Assistant
  • Bonners Ferry, ID
National Provider Identifier
1073559563
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA-797 Issued in ID
Practice address
6488 Chinook St
Bonners Ferry, ID 83805-7515
Phone
(208) 267-8710
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA-797 ID Primary

Addresses

Primary practice location

6488 Chinook St
Bonners Ferry, ID 83805-7515

Mailing address

6488 Chinook St
Bonners Ferry, ID 83805-7515
Phone (208) 267-8710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090519000675 ID Practitioner - Physician Assistant 0749283059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bonners Ferry Family Medicine PLLCGroup PAC ID 3971604166, 7 clinicians

Practice addresses (Care Compare)

6488 Chinook St
Bonners Ferry, ID 83805-7515
Phone (208) 267-8710

Hospital & facility affiliations

  • Eden Home Health Home health agency, Ponderay, ID, CCN 137122
  • Boundary Community Hospital Hospital, Bonners Ferry, ID, CCN 131301
  • Bonner General Hospital Hospital, Sandpoint, ID, CCN 131328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1073559563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6488 CHINOOK ST",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "838057515",
            "telephone_number": "208-267-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6488 CHINOOK ST",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "838057515",
            "telephone_number": "208-267-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORRICKS",
        "first_name": "AMANDA",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonners Ferry, ID

Sources for this page

Verify at the official NPI Registry.