Decorum Health Services

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

Legal business name

DECORUM HEALTH SERVICES

Practice address

3615 W Main St
Salem, VA 24153-1961

Phone

(540) 378-9772

NPI assigned

Apr 28, 2020

Last updated

Mar 7, 2023By 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

Tracy L Zikes, NPNPI 1821467820

Title

Authorized Official President

Phone

(540) 392-3699

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tracy Lynne Zikes, DNP, AGACNP-C, FNP-C

  • Family Nurse Practitioner
  • Rich Creek, VA
  • NPI 1821467820
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1629699913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31494",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232941494",
            "telephone_number": "540-392-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 W MAIN ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241531961",
            "telephone_number": "540-378-9772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Old Virginia Ave",
            "address_purpose": "LOCATION",
            "city": "Rich Creek",
            "state": "VA",
            "postal_code": "241479669",
            "country_code": "US",
            "telephone_number": "540-726-2328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DECORUM HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-28",
        "last_updated": "2023-03-07",
        "certification_date": "2020-04-28",
        "status": "A",
        "authorized_official_last_name": "ZIKES",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL PRESIDENT",
        "authorized_official_telephone_number": "540-392-3699",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE VIRGINIA",
            "identifier": "0024172938",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Wayne Dayton, NP
• Placido De Guzman, M.D.
• Inuka Suchith De Silva, MD
• Martha Newell Debord
• Rachel Erin Decker, COTA/L
• Rebecca Deeter
• Jennifer G Deforest, CRNA
• Gerard Deguzman, M.D.
• Jennifer E Dehaven, CRNA
• Pamela Deisher

• Gerontology Nurse Practitioner in Salem, VA
• Providers in Salem, VA by specialty
• Gerontology Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.