NPIMap

Organization Active NPI

C12 Medical LLC

  • Occupational Therapist
  • Largo, FL
National Provider Identifier
1972071801
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
C12 MEDICAL LLC
Practice address
333 16TH Ave SE
Largo, FL 33771-4407
Phone
(727) 251-7782
NPI assigned
Nov 8, 2018
Last updated
Nov 8, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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

Authorized official

Name
Christian S ChildersNPI 1710102983
Title
OT
Phone
(727) 251-7782

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

333 16TH Ave SE
Largo, FL 33771-4407

Mailing address

8498 108TH Way
Seminole, FL 33772-4318
Phone (727) 251-7782

National Provider Directory

National Provider Directory

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": "1541635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541635200000",
    "number": "1972071801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8498 108TH WAY",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337724318",
            "telephone_number": "727-251-7782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 16TH AVE SE",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337714407",
            "telephone_number": "727-251-7782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C12 MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-08",
        "last_updated": "2018-11-08",
        "status": "A",
        "authorized_official_last_name": "CHILDERS",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OT",
        "authorized_official_telephone_number": "727-251-7782"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; 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.