AGAPE COMMUNITY HEALTH CENTER, INC. (NPI# 1972968402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972968402 |
Entity Type | Organization |
Organization Name | AGAPE COMMUNITY HEALTH CENTER, INC. |
Other Organization Name | AGAPE COMMUNITY HEALTH CENTER, INC. - NW JAX |
Practice Address |
3160 Edgewood Ave W Jacksonville FL 32209-2245 |
Practice Telephone | 9047604904 |
Mailing Telephone | 9047604904 |
Mailing Fax Number | 9047604657 |
Enumeration Date | 2015-12-29 |
Last Update Date | 2016-12-27 |
Authorized Official Name | MS. MIA L JONES (CEO) |
Authorized Official Telephone | 9047604904 |
Is Organization Subpart | Y |
Parent Organization Name | AGAPE COMMUNITY HEALTH CENTER, INC. |
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. - NW Jax | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982069795 | Agape Community Health Center, Inc. | Clinic/Center | 5316 N Pearl St, Jacksonville, FL 32208-5119 | 2015-12-21 |
1578928826 | Agape Community Health Center, Inc. | Clinic/Center | 5460 Blanding Blvd, Jacksonville, FL 32244-1957 | 2015-12-30 |
1962867762 | Agape Community Health Center, Inc. | Clinic/Center | 120 King St, Jacksonville, FL 32204-2410 | 2015-12-21 |
Street Address |
3160 EDGEWOOD AVE W |
City | JACKSONVILLE |
State | FL |
Zip Code | 32209-2245 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336252444 | Charles B. Mcintosh | Pediatrics | 3160 Edgewood Ave W, Jacksonville, FL 32209-2245 | 2006-08-16 |
1013356641 | Reginald L. Sykes, Sr, M.d., P.a. | Family Medicine | 3160 Edgewood Ave W, Jacksonville, FL 32209-2245 | 2013-06-17 |
1801117155 | Celia Kay Judd | Massage Therapist | 3160 Edgewood Ave W, Jacksonville, FL 32209-2245 | 2010-06-21 |
1205079662 | Northwest Jacksonville Pediatrics, P.a. | Pediatrics | 3160 Edgewood Ave W, Jacksonville, FL 32209-2245 | 2009-04-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710506183 | Hayley M Shade | Student in an Organized Health Care Education/Training Program | 655 8th St. W., 4th Floor, Lrc 653-1 West 8th Street, L18, Jacksonville, FL 32209 | 2020-04-15 |
1407484629 | Micah Christine Turpeau | Student in an Organized Health Care Education/Training Program | 580 W. 8th St., Tower II, Suite 6005, Jacksonville, FL 32209 | 2020-04-01 |
1730716366 | Nikki Javia | Student in an Organized Health Care Education/Training Program | 653-1 W 8th St, Fl 4, Lrc Box L16, Jacksonville, FL 32209 | 2020-03-24 |
1336776061 | Samuel Kamoroff | Student in an Organized Health Care Education/Training Program | 653-1 West 8th Street, 4th Floor, Lrc Box L16, Jacksonville, FL 32209 | 2020-03-24 |
1376194092 | Donald Wayne Johnson Jr. | Pharmacist | Uf Health Jacksonville, 655 West 8th Street, Jacksonville, FL 32209 | 2019-09-24 |
1871141838 | Anton Daran Armstrong | Counselor | 921 N. Davis St. Bldg. B, Suite 350, Jacksonville, FL 32209 | 2019-09-03 |
1295296499 | Christian King | Student in an Organized Health Care Education/Training Program | 580 W. 8th St., Tower II, Suite 6005, Jacksonville, FL 32209 | 2019-03-29 |
1013478403 | David William Barton | Orthopaedic Surgery | 655 W 8th St, Box C-126, Jacksonville, FL 32209 | 2019-03-27 |
1912497108 | Lisa Jordan | Adult Companion | 1515 W 31st St, Jacksonville, FL 32209 | 2018-05-14 |
1275020968 | Eloisa Anne Ello-esma | Nurse Practitioner | W. 8th Street, Jacksonville, FL 32209 | 2018-04-18 |
Find all providers in zip 32209 |
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 |
1245695774 | Agape Community Health Center, Inc | Clinic/Center | 3900 University Blvd S Ste 2, Jacksonville, FL 32216-4331 | 2015-12-29 |
Find all providers in JACKSONVILLE |
City | JACKSONVILLE |
Zip Code | 32209 |
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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.