Active NPI
Gary Lee Decker, M.D.
- Surgery Physician
- Pryor, OK
National Provider Identifier
1043274129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 14290
- Practice address
- 1301 NE 1St St
Pryor, OK 74361-8850 - Phone
- (918) 824-7767
- Fax
- (918) 824-6410
- NPI assigned
- Apr 14, 2006
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 14290 | OK | Primary |
Addresses
Primary practice location
1301 NE 1St St
Pryor, OK 74361-8850
Mailing address
1301 NE 1St St
Pryor, OK 74361-8850
Phone (918) 824-7767
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100194650A | Medicaid | OK | |
| 200039950A | Medicaid | OK |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318464000000",
"number": "1043274129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 NE 1ST ST",
"city": "PRYOR",
"state": "OK",
"postal_code": "743618850",
"telephone_number": "918-824-7767",
"fax_number": "918-824-6410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 NE 1ST ST",
"city": "PRYOR",
"state": "OK",
"postal_code": "743618850",
"telephone_number": "918-824-7767",
"fax_number": "918-824-6410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECKER",
"first_name": "GARY",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-14",
"last_updated": "2011-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OK",
"license": "14290",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100194650A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200039950A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pryor, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.