Brent Decker, PH.D., PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY5989 Issued in FL

Legal business name

BRENT DECKER, PH.D., PA

Practice address

11 W 23Rd St
Suite D1
Panama City, FL 32405-7603

Phone

(850) 522-9456

Fax

(850) 522-9094

NPI assigned

Nov 1, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Brent Decker, PH.D.NPI 1427069251

Title

P/V/S/T

Phone

(850) 522-9456

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brent Decker, PH.D.

  • Clinical Psychologist
  • Panama City, FL
  • NPI 1427069251
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1932485141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 W 23RD ST",
            "address_2": "SUITE D1",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324057603",
            "telephone_number": "850-522-9456",
            "fax_number": "850-522-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 W 23RD ST",
            "address_2": "SUITE D1",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324057603",
            "telephone_number": "850-522-9456",
            "fax_number": "850-522-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT DECKER, PH.D., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-01",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "P/V/S/T",
        "authorized_official_telephone_number": "850-522-9456",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY5989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sallyanne Braxton
• Jesse S Breedlove, CRNA
• Bruce Breegle, MA
• Shannon Brehm, LPN
• Henry B Breland, M.D.
• Brent Denley D O P a
• Brent Denley DO PA
• Doron Bresler, DDS
• Bridges of Care Inc
• Bridgewater Emergency Physicians, LLC

• Clinical Psychologist in Panama City, FL
• Providers in Panama City, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.