Active NPI
Randall Scott Decker, PTA
- Physical Therapy Assistant
- Fort Smith, AR
National Provider Identifier
1003112905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 14-01313
- Practice address
- 1000 Fianna Way
Fort Smith, AR 72919 - Phone
- (479) 201-2000
- NPI assigned
- Feb 10, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 14-01313 | KS | Primary |
Addresses
Primary practice location
1000 Fianna Way
Fort Smith, AR 72919
Mailing address
107 N. Lincoln
Hillsboro, KS 67063
Phone (785) 443-5116
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14-01313 | KS | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297296000000",
"number": "1003112905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 N. LINCOLN",
"city": "HILLSBORO",
"state": "KS",
"postal_code": "67063",
"telephone_number": "785-443-5116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 FIANNA WAY",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "72919",
"telephone_number": "479-201-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECKER",
"first_name": "RANDALL",
"middle_name": "SCOTT",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-02-10",
"last_updated": "2011-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KS",
"license": "14-01313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.