Individual provider Active NPI

Decca Singletary, FNP

  • Family Nurse Practitioner
  • Minnetonka, MN
National Provider Identifier
1174932230
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-132901 Issued in AL
Practice address
9900 Bren Rd E
Minnetonka, MN 55343-9664
Phone
(334) 791-4808
NPI assigned
Aug 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-132901 AL
Family Nurse Practitioner 363LF0000X RN241413 GA
Family Nurse Practitioner 363LF0000X 1-132901 AL Primary

Addresses

Primary practice location

9900 Bren Rd E
Minnetonka, MN 55343-9664

Mailing address

14112 Trouville Dr
Tampa, FL 33624-6960
Phone (334) 791-4808

Other practice location 1

9900 Bren Rd E
Minnetonka, MN 55343-9664
Phone (334) 791-4808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200511000379 AK Practitioner - Nurse Practitioner 4688993058 Reassigns benefits to 1 organization
I20220216000133 TX Practitioner - Nurse Practitioner 4688993058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
70.59 of 100Reported as group
Quality
83.37
Promoting interoperability
100
Improvement activities
40
Cost
16.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-132901ALMDRegistered Nurse
RN241413GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Camai Community Health Center, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Seldovia Village Tribe CurrentSince Mar 18, 2024 Accepting new patients
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc CurrentSince Jun 25, 2018 Accepting new patients
Bristol Bay Borough Past Accepting new patients
Alaska Imaging Associates, LLC Past Accepting new patients

Locations

880 East End Rd
Homer, AK 99603
Phone (907) 226-2228

12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (813) 745-2720

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20726/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1407024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1174932230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14112 TROUVILLE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336246960",
            "telephone_number": "334-791-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "334-791-4808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9900 Bren Rd E",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553439664",
            "country_code": "US",
            "telephone_number": "334-791-4808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SINGLETARY",
        "first_name": "DECCA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-03",
        "last_updated": "2020-11-11",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-132901",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN241413",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-132901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.