Individual provider Active NPI

Mary Joan Decker, APRN

  • Family Nurse Practitioner
  • Keller, TX
National Provider Identifier
1295022770
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
512508 Issued in TX
Practice address
101 Bourland Rd Ste D
Keller, TX 76248-3507
Phone
(817) 864-8824
NPI assigned
Jul 5, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 512508 TX Primary

Addresses

Primary practice location

101 Bourland Rd Ste D
Keller, TX 76248-3507

Mailing address

7432 Sean Dr
North Richland Hills, TX 76182-4552
Phone (817) 788-0442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20151107000127 TX Practitioner - Nurse Practitioner 2264742097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Rami Turner DO PLLCGroup PAC ID 3577008697, 2 clinicians

Practice addresses (Care Compare)

101 Bourland Rd
Suite D
Keller, TX 76248-3507
Phone (817) 864-8824

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
512508TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Rami Turner DO PLLC Family CurrentSince Aug 5, 2024 Accepting new patients

Locations

101 Bourland Rd
Ste D
Keller, TX 76248
Phone (817) 864-8824

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25020/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1295022770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7432 SEAN DR",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761824552",
            "telephone_number": "817-788-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BOURLAND RD STE D",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483507",
            "telephone_number": "817-864-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "MARY",
        "middle_name": "JOAN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-05",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "512508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

Verify at the official NPI Registry.