NPI 1366734394 · live from the CMS NPI Registry
Kathryn C Decker, D.P.M.
Podiatrist, Primary Podiatric Medicine in Salt Lake City, UT. National Provider Identifier 1366734394, active.
NPI record
| NPI | 1366734394 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Primary Podiatric Medicine 213EP1101X |
| Practice location | 3130 S Highland Dr Ste B4, Salt Lake City, UT 84106 |
| Practice phone | 801-253-6886 |
| Mailing address | 9980 S 300 W Ste 310, Sandy, UT 84070 |
| Enumerated | May 10, 2011 |
| Last updated | September 4, 2024 |
| Sole proprietor | No |
| Other names | Kathryn Jetter |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist | 213E00000X | 10921738-0501 (UT) |
| Podiatrist, Radiology | 213ER0200X | 10921738-0501 (UT) |
| Podiatrist, Sports Medicine | 213ES0000X | 10921738-0501 (UT) |
| Podiatrist, Foot & Ankle Surgery | 213ES0103X | 10921738-0501 (UT) |
| 213ES0131X | 10921738-0501 (UT) | |
| Podiatrist, Primary Podiatric Medicine primary | 213EP1101X | 10921738-0501 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.