CARECONNECT HEALTH, INC. (NPI# 1275060212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275060212 |
Entity Type | Organization |
Organization Name | CARECONNECT HEALTH, INC. |
Other Organization Name | CARECONNECT CONVENIENT CARE |
Practice Address |
125 Mcdonald Ave Cuthbert GA 39840-5829 |
Mailing Address |
185 Pecan St Shellman GA 39886-2548 |
Practice Telephone | 2292738881 |
Mailing Telephone | 2296795074 |
Mailing Fax Number | 2296795709 |
Enumeration Date | 2017-05-22 |
Last Update Date | 2020-10-01 |
Authorized Official Name | LINDA YOUNG (SECRETARY) |
Authorized Official Telephone | 2292738881 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 003202762A | 05 |
Other Name | Type Code |
---|---|
CareConnect Clinic | Doing Business As Name - Organization |
CareConnect Convenient Care | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467092221 | Careconnect Health, Inc. | Clinic/Center | 130 N Lee St, Forsyth, GA 31029-2122 | 2020-01-09 |
1649810714 | Careconnect Health, Inc. | Clinic/Center | 254 Wright Avenue, Roberta, GA 31078 | 2020-01-07 |
1437798725 | Careconnect Health, Inc. | Clinic/Center | 414 S Frontage Rd Lot 53, Forsyth, GA 31029-3025 | 2020-01-03 |
1184102725 | Careconnect Health, Inc. | Clinic/Center | 9 W Main Street, Alamo, GA 30411 | 2018-08-06 |
1528556990 | Careconnect Health, Inc. | Clinic/Center | 1909 Hwy. 82 West, Suites 3 & 4, Tifton, GA 31793 | 2018-05-01 |
1801302997 | Careconnect Health, Inc. | Clinic/Center | 209 North Camellia Blvd., Fort Valley, GA 31030 | 2017-12-27 |
1679096606 | Careconnect Health, Inc. | Clinic/Center | 110 E 13th Ave, Cordele, GA 31015-4245 | 2017-07-21 |
1912432527 | Careconnect Health, Inc. | Clinic/Center | 1909 Us Highway 82 W, Suite 5, Tifton, GA 31793-8200 | 2017-04-21 |
1699207050 | Careconnect Health, Inc. | Clinic/Center | 822 S Hill St, Griffin, GA 30224-4842 | 2017-04-03 |
1659819357 | Careconnect Health, Inc. | Clinic/Center | 277 Perry Pkwy, Suite C, Perry, GA 31069-8427 | 2017-02-02 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | CARECONNECT HEALTH, INC. | 510 Alston St, Suite B, Richland, GA 31825-6012 |
Street Address |
125 MCDONALD AVE |
City | CUTHBERT |
State | GA |
Zip Code | 39840-5829 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245233832 | Emmanuel Ndaya Ozimba | Family Medicine | 125 Mcdonald Ave, Cuthbert, GA 39840-5829 | 2005-05-27 |
1417501750 | Stephanie Stille Heleski | Nurse Practitioner | 125 Mcdonald Ave, Cuthbert, GA 39840-5829 | 2019-07-25 |
1497036842 | John Achibuem Chitoh | Nurse Practitioner | 125 Mcdonald Ave, Cuthbert, GA 39840-5829 | 2011-08-30 |
1427205459 | John G Bates | Family Medicine | 125 Mcdonald Ave, Cuthbert, GA 39840-5829 | 2008-08-21 |
1285624452 | Hospital Authority of Randolph County | Clinic/Center | 125 Mcdonald Ave, Cuthbert, GA 39840-5829 | 2005-10-27 |
1396749149 | Hospital Authority of Randolph County | Clinic/Center | 125 Mcdonald Ave, Cuthbert, GA 39840-5829 | 2005-06-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366867533 | Rashema Vandetta Warren | Case Manager/Care Coordinator | 90 Villa Nova Street, New Horizons, Cuthbert, GA 39840 | 2014-02-25 |
1417378415 | Temperess Johnson | Adult Companion | 72 Cleborne Street, Cuthbert, GA 39840 | 2013-12-18 |
1730500976 | Mary Gibbs | Case Manager/Care Coordinator | 72 Clebourne Street, Cuthbert, GA 39840 | 2013-12-13 |
1023448917 | Katie Wright | Counselor | 72 Clebourne St, Cuthbert, GA 39840 | 2013-11-14 |
1588952048 | Michael Carr Jr. | Dentist | 84 Court Street, Cuthbert, GA 39840 | 2011-07-19 |
1518286764 | Lisa Ann Hardwick | Occupational Therapy Assistant | 2058 Hghway 82, Cuthbuert, GA 39840 | 2010-05-27 |
1952630154 | Naomi S Jenkins | Counselor | 264 Lumpkin Street, Cuthbert, GA 39840 | 2009-12-17 |
1467647875 | Mental Retardation Waiver Program | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 119 Claborn St., Cuthbert, GA 39840 | 2007-09-10 |
1376614073 | Randolph County Coutny School System | Local Education Agency (LEA) | 3451 Ga Hwy 266, Cuthbert, GA 39840 | 2006-11-13 |
1437632890 | Gary Nell Glover | Community Health Worker | 72 Clebourne Street, Cuthbert, GA 39840 | 2018-09-12 |
Find all providers in zip 39840 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
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1891395620 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 8a Probasco Street Unit 214, Lafayette, GA 30728 | 2020-10-30 |
1366066243 | Health Education Assessment and Leadership Inc | Clinic/Center | 225 Griffin St Nw, Atlanta, GA 30314-3917 | 2020-06-05 |
1851924377 | Valley Healthcare System | Clinic/Center | 1458 Benning Dr, Columbus, GA 31903-2200 | 2020-02-13 |
1952941528 | Curtis V. Cooper Primary Health Care, Inc | Clinic/Center | 400 E Broad St, Savannah, GA 31401-5104 | 2020-01-13 |
1023658523 | Saint Joseph's Mercy Care Services, Inc. | Clinic/Center | 1407 Cobb Parkway Nw, Marietta, GA 30060-6546 | 2020-01-13 |
1467092221 | Careconnect Health, Inc. | Clinic/Center | 130 N Lee St, Forsyth, GA 31029-2122 | 2020-01-09 |
1417597238 | The Family Health Centers of Georgia, Inc | Clinic/Center | 19 John Maddox Dr Nw Ste B, Rome, GA 30165-1477 | 2020-01-09 |
1649810714 | Careconnect Health, Inc. | Clinic/Center | 254 Wright Avenue, Roberta, GA 31078 | 2020-01-07 |
1437798725 | Careconnect Health, Inc. | Clinic/Center | 414 S Frontage Rd Lot 53, Forsyth, GA 31029-3025 | 2020-01-03 |
1285277608 | Saint Joseph's Mercy Care Services, Inc. | Clinic/Center | 1976 Flat Shoals Rd Se Ste B, Atlanta, GA 30316-2857 | 2019-10-18 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.