NPIMap

Individual provider Active NPI

Jacquelyn Bonnie Brooks, C-FNP

  • Family Nurse Practitioner
  • Post Falls, ID
National Provider Identifier
1861402224
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71088 Issued in ID
Practice address
1651 E Polston Ave
Post Falls, ID 83854
Phone
(208) 457-4208
Fax
(208) 457-4197
NPI assigned
Aug 9, 2006
Last updated
Dec 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71088 ID Primary
Family Nurse Practitioner 363LF0000X AP61239730 WA

Addresses

Primary practice location

1651 E Polston Ave
Post Falls, ID 83854

Mailing address

1593 E Polston Ave
Post Falls, ID 83854-5326
Phone (208) 262-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220329002676 WA Practitioner - Nurse Practitioner 5193717791 Reassigns benefits to 2 organizations
I20231115000310 ID Practitioner - Nurse Practitioner 5193717791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Idaho Day Surgery LLCGroup PAC ID 0840101218, 87 clinicians

Practice addresses (Care Compare)

1641 E Polston Ave
Suite 101
Post Falls, ID 83854-7852
Phone (208) 457-4208

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13645CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Dispatchhealth Washington PC CurrentSince Jan 1, 2022 Accepting new patients
North Idaho Day Surgery LLC CurrentSince Nov 1, 2024 Accepting new patients
Multicare Health System CurrentSince Oct 27, 2023 Accepting new patients
Multicare Health System CurrentSince Oct 27, 2023 Accepting new patients
Multicare Health System Current Accepting new patients
Dispatchhealth Advanced Care - Washington PC PastSince Oct 21, 2020 Accepting new patients
Antelope Valley Emergency Medical Associates Inc Past Accepting new patients
Joseph Terrazzino M D Inc PastSince Jan 23, 2017 Accepting new patients
Vahid Mahabadi, MD., Inc Past Accepting new patients

Locations

7600 N Mineral Dr
Ste 450
Dalton Gardens, ID 83815
Phone (208) 457-4208

1593 E Polston Ave
Post Falls, ID 83854
Phone (208) 262-2300

1641 E Polston Ave
Ste 101
Post Falls, ID 83854
Phone (208) 457-4208

1651 E Polston Ave
Post Falls, ID 83854
Phone (208) 457-4208

750 N Syringa St
Ste 100
Post Falls, ID 83854
Phone (208) 262-2600

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

1411 4th Ave
Seattle, WA 98101
Phone (253) 271-9720

920 N Argonne Rd
Ste 115
Spokane Valley, WA 99212
Phone (509) 408-2107

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

6240 Tacoma Mall Blvd
Ste 101
Tacoma, WA 98409
Phone (253) 271-9720

Organizations & group practices 9

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

Hospital & facility affiliations 6

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1861402224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1593 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545326",
            "telephone_number": "208-262-2300",
            "fax_number": "208-262-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "83854",
            "telephone_number": "208-457-4208",
            "fax_number": "208-457-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "JACQUELYN",
        "middle_name": "BONNIE",
        "credential": "C-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "71088",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61239730",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

Verify at the official NPI Registry.