Acute Medical Care PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ACUTE MEDICAL CARE PC

Practice address

1145 Indianapolis Rd
Greencastle, IN 46135-2408

Phone

(765) 653-8453

Fax

(765) 653-8493

NPI assigned

Oct 23, 2006

Last updated

May 30, 2013By 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

Dr. Thomas Houston Black III, MDNPI 1851474167

Title

Ceo

Phone

(765) 653-8453

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790868016. Details of each certification follow.

• CCN 153907 Rural health clinic · Active · Name & address match · Details

Rural health clinic certification: CCN 153907

Legal name

ACUTE MEDICAL CARE PC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

May 28, 2014

Last certification

May 28, 2014

Ownership / control type

1B

Facility address

1145 Indianapolis Road
Greencastle, IN 46135

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.

• Thomas Houston Black III, MD

  • Family Medicine Physician
  • Greencastle, IN
  • NPI 1851474167
  Authorized official Same address or phone

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369872000000",
    "number": "1790868016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 INDIANAPOLIS RD",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461352408",
            "telephone_number": "765-653-8453",
            "fax_number": "765-653-8493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 INDIANAPOLIS RD",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461352408",
            "telephone_number": "765-653-8453",
            "fax_number": "765-653-8493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACUTE MEDICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-05-30",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "HOUSTON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "765-653-8453",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200125540A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Greencastle, IN
• Providers in Greencastle, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.