Cortney Vaughn Decker, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

500-1202 Issued in WI

Practice address

4605 Royal Drive
Eau Claire, WI 54701

Phone

(715) 855-9220

Fax

(715) 855-9225

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 17, 2015 through Mar 17, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Oakpark Dental - Eau Claire

  • General Practice Dentistry
  • Eau Claire, WI
  • NPI 1699837138
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1699709105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 OLD ENGLISH ROAD",
            "city": "ALTOONA",
            "state": "WI",
            "postal_code": "54720",
            "telephone_number": "715-828-2675",
            "fax_number": "715-834-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 ROYAL DRIVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "54701",
            "telephone_number": "715-855-9220",
            "fax_number": "715-855-9225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "CORTNEY",
        "middle_name": "VAUGHN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "500-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett De Kooker
• Alicia Dean, MSW, LCSW
• Decesare Orthopedic Clinic SC
• William F Decesare, MD
• Catharine C Decker, MD
• Stephanie Decker, DPT
• Mackenzie Ann Deffenbaugh, LPC
• Krysti M Deines, LPC, SAC-IT
• Wendy C Deiss, LPN
• Shelley L Dejongh, MS, LPC, CSAC

• General Practice Dentistry in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.