Careconnect Health, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

CARECONNECT HEALTH, INC

Doing business as

CareConnect Convenient Care

Practice address

1424 N Expressway Ste 121-123
Griffin, GA 30223-1753

Phone

(678) 688-2820

Fax

(770) 467-9868

NPI assigned

Nov 19, 2018

Last updated

Jan 6, 2020By 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

Linda Young

Title

Executive Secretary

Phone

(229) 273-8881

Specialties & licenses 1

Addresses

Other names 1

• CareConnect Convenient Care Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083183180. Details of each certification follow.

• CCN 111099 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 111099

Legal name

CARECONNECT HEALTH INC

Doing business as

CARECONNECT CONVENIENT CARE

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Dec 17, 2018

Last certification

Dec 17, 2018

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Nov 7, 1980 in GA

Enrollment address

1424 N Expressway
Ste 121-123
Griffin, GA 30223-1753

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

CLIA laboratory certificates

Tax ID family

Careconnect Health Inc51 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Careconnect Health, Inc

  dba CareConnect Family Practice

  • Federally Qualified Health Center (FQHC)
  • Buena Vista, GA
  • NPI 1154891794
  NPD tax ID
• Careconnect Health, Inc

  dba CareConnect Family Practice

  • Federally Qualified Health Center (FQHC)
  • Americus, GA
  • NPI 1225228307
  NPD tax ID
• Careconnect Health, Inc.

  dba Pediatric Convenient Care

  • Federally Qualified Health Center (FQHC)
  • Moultrie, GA
  • NPI 1013848928
  NPD tax ID
• Careconnect Health, Inc.

  dba Pediatric Urgent Care

  • Federally Qualified Health Center (FQHC)
  • Cordele, GA
  • NPI 1023463510
  NPD tax ID
• Careconnect Health, Inc.

  dba CareConnect Convenient Care and Pediatrics

  • Federally Qualified Health Center (FQHC)
  • Eastman, GA
  • NPI 1043440340
  NPD tax ID
• Careconnect Health, Inc.

  dba CareConnect Family Practice and Pediatrics

  • Federally Qualified Health Center (FQHC)
  • Richland, GA
  • NPI 1063422038
  NPD tax ID
• Careconnect Health, Inc.

  dba CareConnect Convenient Care

  • Federally Qualified Health Center (FQHC)
  • Thomaston, GA
  • NPI 1093190670
  NPD tax ID
• Careconnect Health, Inc.

  dba CareConnect Family Practice

  • Federally Qualified Health Center (FQHC)
  • Butler, GA
  • NPI 1104255934
  NPD tax ID
• Careconnect Health, Inc.

  dba CareConnect Urgent Care

  • Federally Qualified Health Center (FQHC)
  • Cordele, GA
  • NPI 1124266499
  NPD tax ID
• Careconnect Health, Inc.

  dba Americus Urgent Care

  • Federally Qualified Health Center (FQHC)
  • Americus, GA
  • NPI 1134362916
  NPD tax ID
• Careconnect Health, Inc.

  dba CareConnect Family Practice and Pediatrics

  • Federally Qualified Health Center (FQHC)
  • Rochelle, GA
  • NPI 1144401787
  NPD tax ID
• Careconnect Health, Inc.

  dba CareConnect Family Practice

  • Federally Qualified Health Center (FQHC)
  • Alamo, GA
  • NPI 1184102725
  NPD tax ID

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

All facility ownership & control disclosures 26

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Facilities with the same owner 26

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Careconnect Health, Inc.

  dba Pediatric Urgent Care

  • Federally Qualified Health Center (FQHC)
  • Cordele, GA
  • NPI 1023463510

  Careconnect Health Inc

  CMS ownership
• Careconnect Health, Inc.

  dba CareConnect Convenient Care and Pediatrics

  • Federally Qualified Health Center (FQHC)
  • Eastman, GA
  • NPI 1043440340

  Careconnect Health Inc

  CMS ownership
• Careconnect Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Richland, GA
  • NPI 1063436624

  Careconnect Health Inc

  CMS ownership
• Careconnect Health, Inc.

  dba CareConnect Convenient Care

  • Federally Qualified Health Center (FQHC)
  • Thomaston, GA
  • NPI 1093190670

  Careconnect Health Inc

  CMS ownership
• Careconnect Health, Inc.

  dba Americus Urgent Care

  • Federally Qualified Health Center (FQHC)
  • Americus, GA
  • NPI 1134362916

  Careconnect Health Inc

  CMS ownership
• Careconnect Health, Inc.

  dba CareConnect Family Practice

  • Federally Qualified Health Center (FQHC)
  • Alamo, GA
  • NPI 1184102725

  Careconnect Health Inc

  CMS ownership
• Careconnect Health, Inc.

  dba CareConnect Pediatrics

  • Federally Qualified Health Center (FQHC)
  • Moultrie, GA
  • NPI 1255818803

  Careconnect Health Inc

  CMS ownership
• Careconnect Health, Inc.

  dba CareConnect Convenient Care

  • Federally Qualified Health Center (FQHC)
  • Cuthbert, GA
  • NPI 1275060212

  Careconnect Health Inc

  CMS ownership
• Careconnect Health, Inc.

  dba CareConnect Family Practice and Pediatrics

  • Federally Qualified Health Center (FQHC)
  • Ashburn, GA
  • NPI 1316485493

  Careconnect Health Inc

  CMS ownership
• Careconnect Health, Inc.

  dba CareConnect Pediatrics

  • Federally Qualified Health Center (FQHC)
  • Montezuma, GA
  • NPI 1407252638

  Careconnect Health Inc

  CMS ownership
• Careconnect Health, Inc.

  dba Americus OBGYN

  • Federally Qualified Health Center (FQHC)
  • Americus, GA
  • NPI 1447669668

  Careconnect Health Inc

  CMS ownership
• Careconnect Health, Inc.

  dba Pediatric Convenient Care

  • Federally Qualified Health Center (FQHC)
  • Kathleen, GA
  • NPI 1447833926

  Careconnect Health Inc

  CMS ownership

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

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1083183180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5610",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310105610",
            "telephone_number": "229-273-8881",
            "fax_number": "229-273-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 N EXPRESSWAY STE 121-123",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302231753",
            "telephone_number": "678-688-2820",
            "fax_number": "770-467-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARECONNECT HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-19",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "EXECUTIVE SECRETARY",
        "authorized_official_telephone_number": "229-273-8881"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CareConnect Convenient Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CareConnect Convenient Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacqueline Campbell
• Leah C Campbell, MSP, CCC-SLP
• Miranda Campbell, MPT
• Rhonda Cantu, FNP
• Care Rehabilitation Physical Therapy Services, Inc.
• Careconnect Health, Inc. (CareConnect Urgent Care)
• Lanitra Lashai Carey, LPC
• Dothia Mazie Casey
• Nihal Eisa Cassady, M.D.
• Iris Altagracia Castro-Revoredo, M.D.

• Federally Qualified Health Center (FQHC) in Griffin, GA
• Providers in Griffin, GA by specialty
• Federally Qualified Health Center (FQHC) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.
• 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.