Active NPI
Amanda R Harrison, PHARMD
- Pharmacist
- Nampa, ID
National Provider Identifier
1851667182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P6163
- Practice address
- 16700 N Marketplace Blvd
Nampa, ID 83687-7909 - Phone
- (208) 465-3809
- Fax
- (208) 465-3806
- NPI assigned
- Mar 30, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6940 | MT | |
| Pharmacist | 183500000X | 3403 | WY | |
| Pharmacist | 183500000X | PHA0019658 | CO | |
| Pharmacist | 183500000X | P6163 | ID | Primary |
Addresses
Primary practice location
16700 N Marketplace Blvd
Nampa, ID 83687-7909
Mailing address
1171 W Penelope St
Kuna, ID 83634-2366
Phone (208) 922-2008
Other practice location 1
2051 S Cole Rd
Boise, ID 83709-2815
Phone (208) 323-8707
Other practice location 2
173 W 4th St
Kuna, ID 83634-2046
Phone (208) 922-4400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PHA0019658 | CO | MD | Pharmacist |
| P6163 | ID | MD | Pharmacist |
| 3403 | WY | MD | Pharmacist |
| 6940 | MT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578009600000",
"number": "1851667182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1171 W PENELOPE ST",
"city": "KUNA",
"state": "ID",
"postal_code": "836342366",
"telephone_number": "208-922-2008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16700 N MARKETPLACE BLVD",
"city": "NAMPA",
"state": "ID",
"postal_code": "836877909",
"telephone_number": "208-465-3809",
"fax_number": "208-465-3806"
}
],
"practiceLocations": [
{
"address_1": "2051 S Cole Rd",
"address_purpose": "LOCATION",
"city": "Boise",
"state": "ID",
"postal_code": "837092815",
"country_code": "US",
"telephone_number": "208-323-8707",
"fax_number": "208-327-9577",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "173 W 4th St",
"address_purpose": "LOCATION",
"city": "Kuna",
"state": "ID",
"postal_code": "836342046",
"country_code": "US",
"telephone_number": "208-922-4400",
"fax_number": "208-922-4499",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARRISON",
"first_name": "AMANDA",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-30",
"last_updated": "2020-01-03",
"certification_date": "2020-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MT",
"license": "6940",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WY",
"license": "3403",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "PHA0019658",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P6163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.