David H Decker, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

036-067909 Issued in IL

Practice address

710 N 8TH St
Springfield, IL 62702-6324

Phone

(217) 588-7717

Fax

(217) 525-1503

NPI assigned

Jan 9, 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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Board of Trustees of Southern Illinois University

  • Primary Care Clinic/Center
  • Springfield, IL
  • NPI 1396097960
  Medicare reassignment NPD
• Board of Trustees of Southern Illinois University

  • Federally Qualified Health Center (FQHC)
  • Springfield, IL
  • NPI 1558848473
  NPD
• Board of Trustees of Southern Illinois University

  • Federally Qualified Health Center (FQHC)
  • Carbondale, IL
  • NPI 1568210425
  NPD

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1063490043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N 8TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026324",
            "telephone_number": "217-588-7717",
            "fax_number": "217-525-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "DAVID",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036-067909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036067909",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "daviddecker@siusm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "710 N 8th St",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627026324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Martin Nuguid De Venecia, DO
• Caitlin Deady
• Tracy Deal
• Laura Dawn Deaton, PA-C
• Alan J Deckard, M.D.
• Janet C. Declerck, CRNA
• Yara Deeb, MD
• Kenneth Gene Deeke, RPH
• Chad Joseph Defrain, MD
• Quinlan Mae Degroot, FNP-BC

• Child & Adolescent Psychiatry Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Child & Adolescent Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.