Organization Active NPI

Back in Step

  • Prosthetic/Orthotic Supplier
  • Las Vegas, NV
National Provider Identifier
1912362245
Registry record updated Dec 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
NV20151659970 Issued in NV
Legal business name
BACK IN STEP
Practice address
2820 W Charleston Blvd Ste 32
Las Vegas, NV 89102-1934
Phone
(702) 850-2898
Fax
(702) 850-2836
NPI assigned
Dec 31, 2015
Last updated
Dec 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cynthea Clark
Title
Owner
Phone
(702) 850-2898

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X NV20151659970 NV Primary

Addresses

Primary practice location

2820 W Charleston Blvd Ste 32
Las Vegas, NV 89102-1934

Mailing address

2820 W Charleston Blvd Ste 32
Las Vegas, NV 89102-1934
Phone (702) 850-2898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170123003070 NV DME Supplier - Pedorthic Personnel 6901188176 Practice locations: Las Vegas, NV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Back in Step2820 W Charleston Blvd, Las Vegas, NV 89102-1934(702) 850-2898 Commodes, Urinals, Bedpans|Canes and/or Crutches|Walkers|Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Nebulizer Equipment and/or Supplies|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Accepts assignmentParticipating since Aug 31, 2016

National Provider Directory

National Provider Directory

Locations

2820 W Charleston Blvd
Ste 32
Las Vegas, NV 89102
Phone (702) 850-2898

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1451520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482451200000",
    "number": "1912362245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 W CHARLESTON BLVD STE 32",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021934",
            "telephone_number": "702-850-2898",
            "fax_number": "702-850-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 W CHARLESTON BLVD STE 32",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021934",
            "telephone_number": "702-850-2898",
            "fax_number": "702-850-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK IN STEP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-31",
        "last_updated": "2016-12-23",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CYNTHEA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-850-2898"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NV",
            "license": "NV20151659970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.