Active NPI
James Philip Van Decar, M.D.
- Pediatric Neurodevelopmental Disabilities Physician
- Eglin Afb, FL
National Provider Identifier
1083604052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Neurodevelopmental Disabilities Physician
- License
- ME 106290
- Practice address
- 307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302 - Phone
- (850) 883-8780
- NPI assigned
- Oct 21, 2005
- 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 |
|---|---|---|---|---|
| Pediatric Neurodevelopmental Disabilities Physician | 2080P0008X | ME 106290 | FL | Primary |
Addresses
Primary practice location
307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302
Mailing address
307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 106290 | FL | MD | Pediatric Neurodevelopmental Disabilities Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349222400000",
"number": "1083604052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 BOATNER RD STE 114",
"city": "EGLIN AFB",
"state": "FL",
"postal_code": "325421302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 BOATNER RD STE 114",
"city": "EGLIN AFB",
"state": "FL",
"postal_code": "325421302",
"telephone_number": "850-883-8780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN DECAR",
"first_name": "JAMES",
"middle_name": "PHILIP",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-21",
"last_updated": "2012-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0008X",
"taxonomy_group": "",
"desc": "Pediatrics, Neurodevelopmental Disabilities",
"state": "FL",
"license": "ME 106290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eglin Afb, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.