Kristen K Decker, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

001944 Issued in IA

Practice address

24086 Bowens Prairie Rd
Monticello, IA 52310-8101

Phone

(319) 480-8296

NPI assigned

Nov 8, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449360000000",
    "number": "1891096863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24086 BOWENS PRAIRIE RD",
            "city": "MONTICELLO",
            "state": "IA",
            "postal_code": "523108101",
            "telephone_number": "319-480-8296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24086 BOWENS PRAIRIE RD",
            "city": "MONTICELLO",
            "state": "IA",
            "postal_code": "523108101",
            "telephone_number": "319-480-8296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "KRISTEN",
        "middle_name": "K",
        "name_prefix": "Miss",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-08",
        "last_updated": "2015-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT83631",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "001944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1891096863",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA DIETETIC LICENSURE",
            "identifier": "001944",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Ann Brighton
• Camp Courageous of Iowa
• City of Monticello
• Broderick Eugene Clemmons
• County of Jones (Jets Transportation)
• Lacy Shay Doyle, M.A.
• Eastern Iowa Visiting Nurses and Home Health Care, LLC
• Jennifer A Fasnacht, OT
• Philip First, DO
• Gary W. Fisher, OD PC

• Registered Dietitian in Monticello, IA
• Providers in Monticello, IA by specialty
• Registered Dietitian in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2015; 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.