{
"Npi": {
"NPI": "1861676884",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DR. JEROME E. REEVES, DPM, PLLC",
"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": "8451 BEVERLY RD",
"SecondLineMailingAddress": "2T",
"MailingAddressCityName": "KEW GARDENS",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11415-2123",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-441-6271",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "205-07 HILLSIDE AVENUE",
"SecondLinePracticeLocationAddress": "SUITE 15",
"PracticeLocationAddressCityName": "HOLLIS",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11423",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-479-5747",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/27/2007",
"LastUpdateDate": "12/27/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "REEVES",
"AuthorizedOfficialFirstName": "JEROME",
"AuthorizedOfficialMiddleName": "E.",
"AuthorizedOfficialTitle": "PODIATRIC PHYSICIAN",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.P.M.",
"AuthorizedOfficialTelephoneNumber": "718-479-5747",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "N005132",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}