Joel Thomas Deckard

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000018946 Issued in IL

Practice address

8270 Willow Oaks Corporate Dr Ste 700
Fairfax, VA 22031-4529

Phone

(703) 277-2663

NPI assigned

Aug 24, 2023

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1902680366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 SOMERSET PARK DR SE APT 201",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201755696",
            "telephone_number": "765-993-8392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8270 WILLOW OAKS CORPORATE DR STE 700",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314529",
            "telephone_number": "703-277-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKARD",
        "first_name": "JOEL",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "2000018946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Ellen Dearson, M.A., CCC-SLP
• Elijah James Deboe, LPC
• Brian John Decastro, M.D.
• Valeria Decelle
• Emily P Deck, MS, ATC, LAT
• Barry John Decker, M.D.
• Patti P Decorte, CPNP
• Amy M Decroo, PTA
• Jessica M. Dee, CRNA
• John Frederick Deeken, MD

• All providers in Fairfax, VA
• Athletic Trainer in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.