NPI Code Detail JSON Logo

1285500033 NPI number — KICKSTART O&P, LLC

NPI Number: 1285500033
Health Care Provider/Practitioner: KICKSTART O&P, LLC

Information about “1285500033” NPI (KICKSTART O&P, LLC) exists in 1285500033 in HTML format HTML  |  1285500033 in plain Text format TXT  |  1285500033 in PDF (Portable Document Format) PDF  |  1285500033 in an XML format XML  formats.

NPI Number : 1285500033 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1285500033",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "KICKSTART O&P, LLC",
    "ParentOrgTIN": null,
    "OrgName": "KICKSTART O&P, LLC",
    "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": "4651 TELEGRAPH AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "OAKLAND",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94609-2021",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "510-996-4200",
    "MailingAddressFaxNumber": "510-906-4557",
    "FirstLinePracticeLocationAddress": "401 GREGORY LN STE 136",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PLEASANT HILL",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94523-2836",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "510-996-4200",
    "PracticeLocationAddressFaxNumber": "510-906-4557",
    "EnumerationDate": "10/16/2025",
    "LastUpdateDate": "10/16/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LAFRANCE",
    "AuthorizedOfficialFirstName": "TONY",
    "AuthorizedOfficialMiddleName": "L",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "CPO",
    "AuthorizedOfficialTelephoneNumber": "510-996-4200",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "335E00000X",
        "TaxonomyName": "Prosthetic/Orthotic Supplier",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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