William Robert Decker, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

5901000997 Issued in MI

Practice address

1195 Wilson NW
Grand Rapids, MI 49534-6404

Phone

(616) 453-8277

Fax

(616) 453-2002

NPI assigned

Jun 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1023046844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5175 PLAINFIELD NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251048",
            "telephone_number": "616-453-0294",
            "fax_number": "616-726-1492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 WILSON NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495346404",
            "telephone_number": "616-453-8277",
            "fax_number": "616-453-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901000997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480026385",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3506776",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINISTAR",
            "identifier": "1266510001",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Robert Decker, DPM
• Kelly Decker, LMSW
• Kimber Glenn Decker, MA
• Kimberly K Decker, PA
• Stephanie Lynn Decker
• Hannah M Declark, AT
• Madeleine Grace Declercq, MD
• James Michael Decou, MD
• Alicia Ann Decovich, PA
• Emily Dedoyard, PA-C

• Foot & Ankle Surgery Podiatrist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Foot & Ankle Surgery Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.