PEDIATRIC CONVENIENT CARE – NPI #1528556990
Clinic/Center

PEDIATRIC CONVENIENT CARE is an AHC clinic located in TIFTON, GA. NPPES has assigned the NPI number 1528556990 to PEDIATRIC CONVENIENT CARE on May 01, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PEDIATRIC CONVENIENT CARE” is a dba name, the actual legal business name for this organization is CARECONNECT HEALTH, INC.. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 6 years ago on Jan 06, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PEDIATRIC CONVENIENT CARE below.

NPI Profile for
CARECONNECT HEALTH, INC.

NPI Number
1528556990
Enumeration Date

(more than 8 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CARECONNECT HEALTH, INC.
Doing Business As (dba): PEDIATRIC CONVENIENT CARE
Primary location
1909 HWY. 82 WEST
SUITES 3 & 4
TIFTON, GA 31793
Phone: (229) 445-3509 Fax: (229) 445-3513
Mailing address
P.O. BOX 5610
CORDELE, GA 31010
Phone: (229) 273-8881 Fax: (229) 273-8985
Organization Subpart
Yes - PEDIATRIC CONVENIENT CARE is subpart of another organization.
Authorized Official
LINDA YOUNG
EXECUTIVE SECRETARY
Phone: (229) 273-8881
Updated
Certification Date
Jan 06, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.