{
"Npi": {
"NPI": "1063385953",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "RIDE4HEALTH, LLC.",
"ParentOrgTIN": null,
"OrgName": "RIDE4HEALTH PHILADELPHIA NORTH",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2607 WELSH RD APT K306",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PHILADELPHIA",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19114-3335",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "445-201-2888",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2607 WELSH RD APT K306",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PHILADELPHIA",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "19114-3335",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "445-201-2888",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/26/2025",
"LastUpdateDate": "09/26/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SMITH",
"AuthorizedOfficialFirstName": "JAMES",
"AuthorizedOfficialMiddleName": "CHARLES",
"AuthorizedOfficialTitle": "COO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "EMT-P",
"AuthorizedOfficialTelephoneNumber": "814-934-2100",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "344600000X",
"TaxonomyName": "Taxi",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "343900000X",
"TaxonomyName": "Non-emergency Medical Transport (VAN)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}