Jill Susanne Decker, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

4301080589 Issued in MI

Practice address

345 N Division Rd
Suite D
Petoskey, MI 49770-9416

Phone

(231) 347-8382

Fax

(231) 347-6628

NPI assigned

Sep 20, 2006

Last updated

Oct 12, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dennis E McGeath

  dba Petoskey Pediatrics

  • Pediatric Adolescent Medicine Physician
  • Petoskey, MI
  • NPI 1184721318
  NPD (past)
• Petoskey Pediatrics, PC

  • Pediatrics Physician
  • Petoskey, MI
  • NPI 1417545773
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192147200000",
    "number": "1922106301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 N DIVISION RD",
            "address_2": "SUITE D",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709416",
            "telephone_number": "231-347-8382",
            "fax_number": "231-347-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 N DIVISION RD",
            "address_2": "SUITE D",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709416",
            "telephone_number": "231-347-8382",
            "fax_number": "231-347-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "JILL",
        "middle_name": "SUSANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MI",
            "license": "4301080589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4440294",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Teresa Daunter, PH.D
• David R Hunter DPM PC (Petoskey Foot Specialists)
• David R Hunter DPM PC
• Mark W Dawson, RPH
• Trudy E Day, M.S.N., N.P.
• Todd Edward Decker, MD
• Bruce G Deckinga, MD
• John J Degroot, O.D.
• Suzanne C Delmerico, PTA
• Chandra L Delorenzo, DO

• Pediatric Adolescent Medicine Physician in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Pediatric Adolescent Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.