Careconnect Health, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

CARECONNECT HEALTH, INC.

Doing business as

CareConnect Family Practice

Practice address

300 Medical Court
Oglethorpe, GA 31068

Phone

(478) 458-9942

Fax

(478) 458-9969

NPI assigned

Jun 27, 2012

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

Secretary

Phone

(229) 273-8881

Specialties & licenses 1

Addresses

Other names 1

• CareConnect Family Practice 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 1497019194. Details of each certification follow.

• CCN 111959 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 111959

Legal name

CARECONNECT HEALTH INC

Doing business as

CARECONNECT FAMILY PRACTICE

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

May 8, 2013

Last certification

May 8, 2013

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Nov 7, 1980 in GA

Enrollment address

300 Medical CT
Oglethorpe, GA 31068-2000

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

Southwest Georgia Hlthcare51 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 Pediatric Convenient Care

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

  dba CareConnect Pediatrics

  • Federally Qualified Health Center (FQHC)
  • Montezuma, GA
  • NPI 1407252638
  NPD tax ID
• Careconnect Health, Inc.

  dba CareConnect OBGYN

  • Federally Qualified Health Center (FQHC)
  • Cordele, GA
  • NPI 1407411986
  NPD tax ID
• Careconnect Health, Inc.

  dba CareConnect Family Medicine

  • Federally Qualified Health Center (FQHC)
  • Cordele, GA
  • NPI 1427815737
  NPD tax ID
• Careconnect Health, Inc.

  dba Americus OBGYN

  • Federally Qualified Health Center (FQHC)
  • Americus, GA
  • NPI 1447669668
  NPD tax ID
• Careconnect Health, Inc.

  dba Pediatric Convenient Care

  • Federally Qualified Health Center (FQHC)
  • Kathleen, GA
  • NPI 1447833926
  NPD tax ID
• Careconnect Health, Inc.

  dba CareConnect Family Medicine

  • Federally Qualified Health Center (FQHC)
  • Americus, GA
  • NPI 1457201378
  NPD tax ID
• Careconnect Health, Inc.

  dba CareConnect Family Practice

  • Federally Qualified Health Center (FQHC)
  • Cordele, GA
  • NPI 1457581738
  NPD tax ID
• Careconnect Health, Inc.

  dba CareConnect Convenient Care

  • Federally Qualified Health Center (FQHC)
  • Forsyth, GA
  • NPI 1467092221
  NPD tax ID
• Careconnect Health, Inc.

  dba CareConnect Convenient Care

  • Federally Qualified Health Center (FQHC)
  • Ellaville, GA
  • NPI 1487036075
  NPD tax ID

Locations

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.

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1497019194",
    "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": "300 MEDICAL COURT",
            "city": "OGLETHORPE",
            "state": "GA",
            "postal_code": "31068",
            "telephone_number": "478-458-9942",
            "fax_number": "478-458-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARECONNECT HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-27",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CareConnect Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julie Ann Beery
• Stephanie Burris, NP-C
• Carl F Williams III
• Richard K Chase, D.O.
• Peter Sebastian Cimino III, DDS
• Diamond K Clay
• Hugh Glenn Cross, RPH

• Federally Qualified Health Center (FQHC) in Oglethorpe, GA
• Providers in Oglethorpe, 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.