DR. JILL SUSANNE DECKER M.D. NPI 1922106301

NPI Information

  • NPI: 1922106301
  • Provider Name: DR. JILL SUSANNE DECKER, M.D.
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Individual
  • Address: 345 N DIVISION RD
    SUITE D
    PETOSKEY, MI
    ZIP 49770
  • Phone: (231) 347-8382

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NPI Details

DR. Jill Susanne Decker, M.D. is an adolescent medicine pediatrics in Petoskey, MI. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. DR. Jill Susanne Decker, M.D. NPI is 1922106301. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

345 N DIVISION RD
SUITE D
PETOSKEY, MI
ZIP 49770-416
Phone: (231) 347-8382
Fax: (231) 347-6628

The enumeration date for this NPI number is 9/20/2006 and was last updated on 10/12/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080A0000XPediatricsAdolescent Medicine4301080589MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14440294MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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