Careconnect Health, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

CARECONNECT HEALTH, INC.

Doing business as

CareConnect OBGYN

Practice address

412 E 4TH Ave
Cordele, GA 31015

Phone

(229) 273-1243

Fax

(229) 273-1247

NPI assigned

May 9, 2019

Last updated

May 4, 2022By 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 OBGYN 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 1407411986. Details of each certification follow.

• CCN 111110 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 111110

Legal name

CARECONNECT HEALTH INC

Doing business as

CARECONNECT OBGYN

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jun 28, 2019

Last certification

Jun 28, 2019

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Nov 7, 1980 in GA

Enrollment address

412 E 4TH Ave
Cordele, GA 31015-3619

Tax ID family

Plains Medical Center51 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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)
  • Thomaston, GA
  • NPI 1437009040
  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
• Careconnect Health, Inc.

  dba CareConnect Pediatrics

  • Federally Qualified Health Center (FQHC)
  • Moultrie, GA
  • NPI 1255818803
  NPD tax ID
• Careconnect Health, Inc.

  dba CareConnect Urgent Care

  • Federally Qualified Health Center (FQHC)
  • Tifton, GA
  • NPI 1265720668
  NPD tax ID
• Careconnect Health, Inc.

  dba CareConnect Convenient Care

  • Federally Qualified Health Center (FQHC)
  • Cuthbert, GA
  • NPI 1275060212
  NPD tax ID
• Careconnect Health, Inc.

  dba Pediatric Convenient Care

  • Federally Qualified Health Center (FQHC)
  • Leesburg, GA
  • NPI 1285346270
  NPD tax ID
• Careconnect Health, Inc.

  dba CareConnect Family Practice and Pediatrics

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

Locations

All disclosed owners & managing parties 11

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.

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651622400000",
    "number": "1407411986",
    "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": "412 E 4TH AVE",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "31015",
            "telephone_number": "229-273-1243",
            "fax_number": "229-273-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARECONNECT HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-09",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "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 OBGYN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CareConnect OBGYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Buford, CCC/SLP
• Shonterrian L. Butts
• Kimmie A Carden, PA-C
• Careconnect Health, Inc. (Pediatric Urgent Care)
• Careconnect Health, Inc. (CareConnect Urgent Care)
• Careconnect Health, Inc. (CareConnect Family Medicine)
• Careconnect Health, Inc. (CareConnect Family Practice)
• Careconnect Health, Inc. (New Hope Clinic)
• Careconnect Health, Inc. (CareConnect Clinic)
• Linda Carter, PH.D.

• Federally Qualified Health Center (FQHC) in Cordele, GA
• Providers in Cordele, 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 May 4, 2022; 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.