Dpmdeckerprct LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

000853 Issued in CT

Legal business name

DPMDECKERPRCT LLC

Doing business as

Jennifer Decker, DPM

Practice address

300 Hebron Ave
Suite 211
Glastonbury, CT 06033-2176

Phone

(860) 657-3668

Fax

(860) 657-1678

NPI assigned

Apr 19, 2011

Last updated

Apr 19, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Decker, DPM

Title

Owner

Phone

(860) 657-3668

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Decker, DPM Doing business as

Locations

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303171200000",
    "number": "1407146897",
    "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": "2011-04-19",
        "last_updated": "2011-04-19",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-657-3668",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CT",
            "license": "000853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jennifer Decker, DPM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott Dolin, MD
• Rachel A Donovan, CNM
• Melissa Faith Dorfman, COTA L
• Charlene Elizabeth Dotts-Mete, M.S., L.P.C.
• Kimberly Ann Doyle, L.C.S.W.
• Dpmdeckerprct, LLC
• Dr. Beth Giurelli Psy.D. LLC
• Martha Elizabeth Drummond, M.ED. CCC-A
• Kathryn Mary Dube
• Jennifer Lee Dubicki, LAC

• Foot & Ankle Surgery Podiatrist in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Foot & Ankle Surgery Podiatrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.