AGAPE COMMUNITY HEALTH CENTER, INC (NPI# 1245695774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245695774 |
| Entity Type | Organization |
| Organization Name | AGAPE COMMUNITY HEALTH CENTER, INC |
| Other Organization Name | AGAPE COMMUNITY HEALTH CENTER, INC. - SOUTH JAX |
| Practice Address |
3900 University Blvd S Ste 2 Jacksonville FL 32216-4331 |
| Mailing Address |
120 King Street Jacksonville FL 32204-4393 |
| Practice Telephone | 9047604940 |
| Practice Fax Number | 9046472481 |
| Mailing Telephone | 9047604940 |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2020-09-09 |
| Authorized Official Name | MS. MIA L JONES (CEO) |
| Authorized Official Telephone | 9047604904 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
N04000004094 | FL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Agape Community Health Center, Inc. - South Jax | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326668351 | Agape Community Health Center, Inc | Clinic/Center | 6024 Merrill Rd, Jacksonville, FL 32277-3427 | 2020-04-20 |
| 1376178814 | Agape Community Health Center, Inc | Clinic/Center | 1680 Dunn Ave Ste 35, Jacksonville, FL 32218-4744 | 2020-03-05 |
| Street Address |
3900 UNIVERSITY BLVD S STE 2 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216-4331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740389683 | Chandroutie Daisy Santoo-vazquez | Nurse Practitioner | 3900 University Blvd S Ste 2, Jacksonville, FL 32216-4331 | 2006-09-21 |
| 1992177349 | Nikita M Richardson | Nurse Practitioner | 3900 University Blvd S Ste 2, Jacksonville, FL 32216-4331 | 2015-10-26 |
| 1851773154 | Monica Johnson | Nurse Practitioner | 3900 University Blvd S Ste 2, Jacksonville, FL 32216-4331 | 2015-06-23 |
| 1053638551 | Shannon Denise Shea | Pediatrics | 3900 University Blvd S Ste 2, Jacksonville, FL 32216-4331 | 2010-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518469527 | Special Health Resources for Texas, Incorporated | Clinic/Center | 1011 College Street, Jacksonville, TX 75766-3307 | 2018-03-06 |
| 1982069795 | Agape Community Health Center, Inc. | Clinic/Center | 5316 N Pearl St, Jacksonville, FL 32208-5119 | 2015-12-21 |
| 1497010425 | Fl Department of Health | Clinic/Center | 1736 University Blvd S, Jacksonville, FL 32216-8929 | 2012-07-05 |
| 1578892485 | Grandmary's House | Clinic/Center | 4828 Evanston Rd, Jacksonville, FL 32208 | 2009-12-24 |
| 1326668351 | Agape Community Health Center, Inc | Clinic/Center | 6024 Merrill Rd, Jacksonville, FL 32277-3427 | 2020-04-20 |
| 1376178814 | Agape Community Health Center, Inc | Clinic/Center | 1680 Dunn Ave Ste 35, Jacksonville, FL 32218-4744 | 2020-03-05 |
| 1760963516 | Arcare | Clinic/Center | 1400 Braden St Ste 1, Jacksonville, AR 72076-3721 | 2018-08-28 |
| 1649628009 | Board of Trustees of Southern Illinois University | Clinic/Center | 345 W State St, Jacksonville, IL 62650-1879 | 2016-05-26 |
| 1578928826 | Agape Community Health Center, Inc. | Clinic/Center | 5460 Blanding Blvd, Jacksonville, FL 32244-1957 | 2015-12-30 |
| 1316302847 | Agape Community Health Mobile Unit | Clinic/Center | 1880 Edgewood Ave W, Jacksonville, FL 32208-3021 | 2015-12-29 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
Please comment or provide details below to improve the information on AGAPE COMMUNITY HEALTH CENTER, INC.
| 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.