C3 Powered by Absolutecare, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

C3 POWERED BY ABSOLUTECARE, LLC

Practice address

36 S Paca St
Baltimore, MD 21201-1735

Phone

(410) 328-3117

NPI assigned

Oct 12, 2018

Last updated

Feb 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas J Trently

Title

Cfo

Phone

(443) 738-0281

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1539302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1285109520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 PEACHTREE RD NW STE 232",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091314",
            "telephone_number": "404-231-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 S PACA ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011735",
            "telephone_number": "410-328-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C3 POWERED BY ABSOLUTECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-12",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "TRENTLY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "443-738-0281"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "887274100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.