Kathryn C Decker, D.P.M.

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

10921738-0501 Issued in UT

Practice address

3130 S Highland Dr Ste B4
Salt Lake City, UT 84106-3095

Phone

(801) 253-6886

Fax

(801) 253-6888

NPI assigned

May 10, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other names 1

• Dr. Kathryn C Jetter Former name

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ellsworth Foot and Ankle ClinicGroup PAC ID 2062778160, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mark'S Hospital Hospital, Salt Lake City, UT, CCN 460047

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Ellsworth Foot and Ankle Clinic

  • Foot & Ankle Surgery Podiatrist
  • Riverton, UT
  • NPI 1942549795
  Medicare reassignment Care Compare group NPD
• Amble Medical

  • Podiatrist
  • Sandy, UT
  • NPI 1134865595
  Medicare reassignment NPD
• Ellsworth Foot and Ankle Clinic

  • Podiatrist
  • Provo, UT
  • NPI 1932878030
  NPD
• Amble Medical

  • Podiatrist
  • Mesquite, NV
  • NPI 1982496253
  NPD

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

• Northern Utah Healthcare Corporation

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1164469243
  Care Compare affiliation

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1366734394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9980 S 300 W STE 310",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840703654",
            "telephone_number": "801-253-6886",
            "fax_number": "385-900-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 S HIGHLAND DR STE B4",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063095",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "KATHRYN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-10",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "UT",
            "license": "10921738-0501",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "UT",
            "license": "10921738-0501",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "UT",
            "license": "10921738-0501",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "UT",
            "license": "10921738-0501",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "UT",
            "license": "10921738-0501",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "UT",
            "license": "10921738-0501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "JETTER",
            "middle_name": "C",
            "prefix": "DR.",
            "credential": "D.P.M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caelyn Decesare
• Christopher Burr Dechet, M.D.
• Pilar Weiss Dechet, MD
• Chad Decker
• Jessica Louise Decker, CMHC
• Lori Decker, P.A.
• Mikaela Decoster, MD
• Jennifer Ann Decou, M.D.
• Michele R Decremer, LCSW
• Jean Elizabeth Dedrick-Zehnder, M.D.

• Primary Podiatric Medicine Podiatrist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Primary Podiatric Medicine Podiatrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.