Individual provider Active NPI

Adam Decatur, PHARMD

  • Pharmacist
  • Brunswick, ME
National Provider Identifier
1174895825
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PR5349 Issued in ME
Practice address
329 Maine St
Brunswick, ME 04011-3310
Phone
(207) 373-2235
NPI assigned
Jan 27, 2012
Last updated
Jan 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PR5349 ME Primary
Psychiatric Pharmacist 1835P1300X PR5349 ME

Addresses

Primary practice location

329 Maine St
Brunswick, ME 04011-3310

Mailing address

329 Maine St
Brunswick, ME 04011-3310
Phone (207) 373-2235

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
PR5349MEMDPsychiatric Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1174895825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 MAINE ST",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040113310",
            "telephone_number": "207-373-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 MAINE ST",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040113310",
            "telephone_number": "207-373-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECATUR",
        "first_name": "ADAM",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-27",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR5349",
            "primary": true
        },
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "ME",
            "license": "PR5349",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.

Verify at the official NPI Registry.