Organization Active NPI

Connect Care Medical LLC

  • Diabetes Educator Registered Nurse
  • Savannah, GA
National Provider Identifier
1154013373
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
Legal business name
CONNECT CARE MEDICAL LLC
Practice address
707 Beauregard St
Savannah, GA 31405-5902
Phone
(912) 667-2233
NPI assigned
May 25, 2023
Last updated
Jun 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Charles Wendell Baines
Title
Owner
Phone
(912) 667-2233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WD0400X Primary

Addresses

Primary practice location

707 Beauregard St
Savannah, GA 31405-5902

Mailing address

707 Beauregard St
Savannah, GA 31405-5902
Phone (912) 667-2233

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": "1684972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1154013373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 BEAUREGARD ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055902",
            "telephone_number": "912-667-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 BEAUREGARD ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055902",
            "telephone_number": "912-667-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECT CARE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "BAINES",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "WENDELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-667-2233"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.