{
"Npi": {
"NPI": "1740597202",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NEXT STEP MEDICAL CORP",
"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": "4501 N WITCHDUCK RD STE H",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VIRGINIA BEACH",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23455-6217",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "757-802-3210",
"MailingAddressFaxNumber": "866-421-0397",
"FirstLinePracticeLocationAddress": "4501 N WITCHDUCK RD STE H",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VIRGINIA BEACH",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23455",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "757-802-3210",
"PracticeLocationAddressFaxNumber": "866-421-0397",
"EnumerationDate": "09/06/2010",
"LastUpdateDate": "08/28/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DAVIS",
"AuthorizedOfficialFirstName": "CHARLES",
"AuthorizedOfficialMiddleName": "STANLEY",
"AuthorizedOfficialTitle": "ORTHOTIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "III",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "757-802-3210",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "246821-R",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": "2018-2468-21-R",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}