{
"Npi": {
"NPI": "1700324522",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "ORTHOTIC HOLDINGS INCORPORATED",
"ParentOrgTIN": null,
"OrgName": "SAFESTEP, 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": "2905 VETERANS MEMORIAL HWY STE 2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RONKONKOMA",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11779-7655",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "866-712-7837",
"MailingAddressFaxNumber": "631-392-7133",
"FirstLinePracticeLocationAddress": "2905 VETERANS MEMORIAL HWY STE 2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RONKONKOMA",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11779-7655",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "866-712-7837",
"PracticeLocationAddressFaxNumber": "631-392-7133",
"EnumerationDate": "02/01/2017",
"LastUpdateDate": "03/27/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WHITE",
"AuthorizedOfficialFirstName": "JOSH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "VP",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPM, CPED",
"AuthorizedOfficialTelephoneNumber": "973-945-6827",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": "CPED4258",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}