Active NPI
Michael Donahue Decker, MD
- Infectious Disease Physician
- Baxter, TN
National Provider Identifier
1710212840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- MD0000014250
- Practice address
- 12500 Cookeville Boatdock Rd
Baxter, TN 38544-4851 - Phone
- (931) 239-3663
- Fax
- (908) 927-8674
- NPI assigned
- Oct 7, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | MD0000014250 | TN | Primary |
Addresses
Primary practice location
12500 Cookeville Boatdock Rd
Baxter, TN 38544-4851
Mailing address
PO Box 425
Baxter, TN 38544-0425
Phone (931) 239-3663
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD0000014250 | TN | MD | Infectious Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491696000000",
"number": "1710212840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 425",
"city": "BAXTER",
"state": "TN",
"postal_code": "385440425",
"telephone_number": "931-239-3663",
"fax_number": "908-927-8674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12500 COOKEVILLE BOATDOCK RD",
"city": "BAXTER",
"state": "TN",
"postal_code": "385444851",
"telephone_number": "931-239-3663",
"fax_number": "908-927-8674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECKER",
"first_name": "MICHAEL",
"middle_name": "DONAHUE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-10-07",
"last_updated": "2017-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "TN",
"license": "MD0000014250",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baxter, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.