Careconnect Health, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

CARECONNECT HEALTH, INC.

Practice address

636 2ND Avenue, SW
Rochelle, GA 31079-2046

Phone

(229) 365-2570

Fax

(229) 365-2571

NPI assigned

Nov 26, 2007

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

Secretary

Phone

(229) 273-8881

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CareConnect Family Practice and Pediatrics Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Federally qualified health center certification: CCN 111902

Legal name

CARECONNECT HEALTH INC

Doing business as

CARECONNECT FAMILY PRACTICE AND PEDIATRICS

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Feb 1, 2008

Last certification

Feb 1, 2008

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Nov 7, 1980 in GA

Enrollment address

636 2ND Avenue SW
Rochelle, GA 31079-2046

Tax ID family

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

Organizations with this tax ID in the same state 21

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

• Careconnect Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Griffin, GA
  • NPI 1083183180
  NPD tax ID
• Careconnect Health, Inc

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

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

  • Federally Qualified Health Center (FQHC)
  • Thomaston, GA
  • NPI 1437009040
  NPD tax ID
• Careconnect Health, Inc.

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

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

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

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

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

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

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

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

All disclosed owners & managing parties 12

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 27

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

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

CLIA laboratory certificates

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1144401787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 5610",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310101514",
            "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": "636 2ND AVENUE, SW",
            "city": "ROCHELLE",
            "state": "GA",
            "postal_code": "310792046",
            "telephone_number": "229-365-2570",
            "fax_number": "229-365-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARECONNECT HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "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": "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "654828836A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CareConnect Family Practice and Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Rochelle, GA
• 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.