Individual provider Active NPI

Kimberlee Dawne Decker, DNP APRN FNP-BC

  • Family Nurse Practitioner
  • Lewistown, MT
National Provider Identifier
1184803470
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NUR-APRN-LIC-100952 Issued in MT
Practice address
611 NE Main St Ste 2
Lewistown, MT 59457-4000
Phone
(406) 350-4067
Fax
(406) 535-5837
NPI assigned
Nov 2, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NUR-RN-LIC49384 MT
Family Nurse Practitioner 363LF0000X NUR-APRN-LIC-100952 MT Primary

Addresses

Primary practice location

611 NE Main St Ste 2
Lewistown, MT 59457-4000

Mailing address

611 NE Main St Ste 2
Lewistown, MT 59457-4000
Phone (406) 350-4067

Other identifiers 1

IdentifierTypeStateIssuer
1184803470MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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

Enrollment IDStateProvider typePAC IDDetails
I20121228000130 MT Practitioner - Nurse Practitioner 6406041953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

505 W Main St
Suite 212
Lewistown, MT 59457-5703
Phone (406) 350-4067

611 NE Main St
Suite 2
Lewistown, MT 59457-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NUR-APRN-LIC-100952MTMDFamily Nurse Practitioner
NUR-RN-LIC49384MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Total Family Care PLLP Family CurrentSince Aug 15, 2016 Accepting new patients
Central Montana Community Health Center, Inc. Past Accepting new patients

Locations

611 NE Main St
Ste 2
Lewistown, MT 59457
Phone (406) 350-4067

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14642/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kimberlee.decker.1@14642.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1184803470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 NE MAIN ST STE 2",
            "city": "LEWISTOWN",
            "state": "MT",
            "postal_code": "594574000",
            "telephone_number": "406-350-4067",
            "fax_number": "406-535-5837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 NE MAIN ST STE 2",
            "city": "LEWISTOWN",
            "state": "MT",
            "postal_code": "594574000",
            "telephone_number": "406-350-4067",
            "fax_number": "406-535-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "KIMBERLEE",
        "middle_name": "DAWNE",
        "name_prefix": "Dr.",
        "credential": "DNP APRN FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "NUR-RN-LIC49384",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "NUR-APRN-LIC-100952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184803470",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewistown, MT

Sources for this page

Verify at the official NPI Registry.