NPIMap

Organization Active NPI

Dpmdeckerprct, LLC

  • Durable Medical Equipment & Medical Supplies
  • Glastonbury, CT
National Provider Identifier
1386922151
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
000853 Issued in CT
Legal business name
DPMDECKERPRCT, LLC
Practice address
300 Hebron Ave
Suite 211
Glastonbury, CT 06033-2176
Phone
(860) 657-3668
Fax
(860) 657-1678
NPI assigned
Jul 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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

Authorized official

Name
Jennifer R Decker, DPMNPI 1104092113
Title
Owner/Podiatrist
Phone
(860) 657-3668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 000853 CT Primary

Addresses

Primary practice location

300 Hebron Ave
Suite 211
Glastonbury, CT 06033-2176

Mailing address

196 Parkway S
Suite 304
Waterford, CT 06385-1234
Phone (860) 442-7027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1311811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311811200000",
    "number": "1386922151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 PARKWAY S",
            "address_2": "SUITE 304",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851234",
            "telephone_number": "860-442-7027",
            "fax_number": "860-437-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HEBRON AVE",
            "address_2": "SUITE 211",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332176",
            "telephone_number": "860-657-3668",
            "fax_number": "860-657-1678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DPMDECKERPRCT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-28",
        "last_updated": "2011-07-28",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/PODIATRIST",
        "authorized_official_telephone_number": "860-657-3668",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "000853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2011; 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.