CARECONNECT HEALTH, INC. (NPI# 1649810714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649810714 |
| Entity Type | Organization |
| Organization Name | CARECONNECT HEALTH, INC. |
| Other Organization Name | CARECONNECT FAMILY PRACTICE |
| Practice Address |
254 Wright Avenue Roberta GA 31078 |
| Mailing Address |
1011 Us Hwy 341 North Roberta GA 31078 |
| Practice Telephone | 4788365007 |
| Mailing Telephone | 2298873324 |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2020-08-19 |
| Authorized Official Name | LINDA YOUNG (EXECUTIVE 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 | TAX IDENTIFICATION NUMBER | ========= | 01 |
| Other Name | Type Code |
|---|---|
| CareConnect Family Practice | 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 |
| 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 |
| 1023463510 | Careconnect Health, Inc. | Clinic/Center | 1007 E 16th Ave, Suite A, Cordele, GA 31015-4549 | 2016-05-03 |
| 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 |
254 WRIGHT AVENUE |
| City | ROBERTA |
| State | GA |
| Zip Code | 31078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053870451 | Lifepoint Ambulance LLC | Ambulance | 1011 Hwy 341 North, Suite 20 A, Roberta, GA 31078 | 2019-03-15 |
| 1114195914 | Phoenix Center Community Service Board | Community/Behavioral Health | 80 Wright Ave, Roberta, GA 31078 | 2008-02-14 |
| 1669517595 | Roberta Drug Co Inc | Pharmacy | 4 Wright Ave, Roberta, GA 31078 | 2007-02-20 |
| 1083776520 | Brentwood Nursing LLC | Skilled Nursing Facility | 280 Myrtle Drive, Roberta, GA 31078 | 2006-12-14 |
| 1679583686 | Crawford County Health Department | Public Health or Welfare | 301 Mccrary St, Roberta, GA 31078 | 2006-08-09 |
| 1356505051 | Freddy N. Gaton | Family Medicine | 106 Mccrary Ave, Roberta, GA 31078 | 2008-07-11 |
| 1487746293 | Orlando Garcia Balcos | General Practice | 170 Wright Avenue, Roberta, GA 31078-0128 | 2006-09-29 |
| 1992932768 | Crawford County Board of Education | Local Education Agency (LEA) | 190 E Crusselle St, Roberta, GA 31078-4865 | 2009-06-18 |
| 1619329307 | Kenneth Hortman | Denturist | 143 E Crusselle St, Roberta, GA 31078-4866 | 2016-07-06 |
| 1760041107 | Lauren Ashley Sutton | Nurse Practitioner | 141 Mccrary Ave, Roberta, GA 31078-4915 | 2019-06-10 |
| Find all providers in zip 31078 | ||||
| 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 |
| 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 |
| 1467094649 | South Central Primary Care Center, Inc | Clinic/Center | 149 Chieftain Cir, Ocilla, GA 31774-2231 | 2019-10-09 |
| 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.