Bret Decker, CAS, ADC-T

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

516 S Pokegama Ave
Grand Rapids, MN 55744-3800

Phone

(218) 327-2001

Fax

(218) 327-0456

NPI assigned

May 23, 2018

Last updated

Jun 16, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1063903268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 S POKEGAMA AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443800",
            "telephone_number": "218-327-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 S POKEGAMA AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443800",
            "telephone_number": "218-327-2001",
            "fax_number": "218-327-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "BRET",
        "credential": "CAS, ADC-T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jim S. Davis, CRNA
• Nathan Jim Davis, CRNA
• Ryan James Davis, D,C,
• Jessica Jo Day, NURSE PRACTITIONER
• Joshua Adam Day
• Deer River Healthcare Center Inc (Essentia Health Grand Rapids Clinic)
• Deer River Healthcare Center, Inc. (Essentia Health Grand Rapids Clnic)
• Angela Degrio, M.D.
• Arie Degrio
• Rhea Lou Valdez Del Rosario, PMHNP

• Addiction (Substance Use Disorder) Counselor in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.