Lawrence Andrew Decker, PAC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

PA2006-0011 Issued in NM

Practice address

3451 N Butler Ave
Farmington, NM 87401

Phone

(505) 566-1915

Fax

(505) 566-1918

NPI assigned

Nov 2, 2005

Last updated

Apr 23, 2021By 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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rehoboth McKinley Christian Health Care Services, Inc.Group PAC ID 1759293855, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rehoboth McKinley Christian Health Care Services Hospital, Gallup, NM, CCN 321313

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rehoboth McKinley Christian Health Care Services, Inc

  • Critical Access Hospital
  • Gallup, NM
  • NPI 1689784506
  Medicare reassignment Care Compare group NPD (past)
• Rehoboth McKinley Christian Health Care Services, Inc

  • Rural Health Clinic/Center
  • Gallup, NM
  • NPI 1689779860
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Rehoboth McKinley Christian Health Care Services, Inc

  • Rural Health Clinic/Center
  • Gallup, NM
  • NPI 1689779860

  Hospital

  Care Compare affiliation
• Rehoboth McKinley Christian Health Care Services, Inc.

  dba RMCHCS Hospital

  • Critical Access Hospital
  • Gallup, NM
  • NPI 1720084999
  Care Compare affiliation

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1093706699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3451 N BUTLER AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874012357",
            "telephone_number": "505-566-1915",
            "fax_number": "505-566-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 N BUTLER AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "87401",
            "telephone_number": "505-566-1915",
            "fax_number": "505-566-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "LAWRENCE",
        "middle_name": "ANDREW",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NM",
            "license": "PA2006-0011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "66439833",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "875114",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19375336",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carlene R. Deal-Smith
• Regina Deale
• Victoria Dearly
• Spencer Terence Debauche
• Peter John Debuck, DMD
• Nicole K Deherrera, LISW
• Matthew Dekay, M.D.
• Villa Auleen Del Carmen, MD
• Samara Deleon, LMSW
• Dawn Deneen, LBSW

• Urgent Care Clinic/Center in Farmington, NM
• Providers in Farmington, NM by specialty
• Urgent Care Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.