Individual provider Active NPI

Amanda Sue Kent, D.O.

  • Diagnostic Radiology Physician
  • Jacksonville, FL
National Provider Identifier
1023213378
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
OS13930 Issued in FL
Practice address
1536 N Jefferson St
Jacksonville, FL 32209-6525
Phone
(904) 470-6900
NPI assigned
Jun 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 81349 GA
Diagnostic Radiology Physician 2085R0202X OS13930 FL Primary

Addresses

Primary practice location

1536 N Jefferson St
Jacksonville, FL 32209-6525

Mailing address

1536 N Jefferson St
Jacksonville, FL 32209-6525
Phone (904) 470-6900

Other practice location 1

8375 Dix Ellis Trl Ste 201
Jacksonville, FL 32256-8241
Phone (904) 399-5550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160621001325 FL Practitioner - Diagnostic Radiology 3072804178 Reassigns benefits to 3 organizations
I20190124003940 GA Practitioner - Diagnostic Radiology 3072804178 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.75 of 100Reported as group
Quality
96.18
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
78.06 of 100Reported as group
Quality
72.79
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
81349GAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Radiology Associates LLC Diagnostic Radiology CurrentSince Aug 1, 2020 Accepting new patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince Jun 1, 2017 Accepting new patients
University of Florida Jacksonville Physicians Inc Diagnostic Radiology CurrentSince Jul 1, 2016 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 1, 2016 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Diagnostic Radiology Current Accepting new patients
Northside Imaging LLC Diagnostic Radiology PastSince Aug 1, 2020 Accepting new patients

Locations

1250 S 18th St
Fernandina Beach, FL 32034
Phone (904) 202-2087

14550 Old St Augustine Rd
Jacksonville, FL 32258
Phone (904) 202-5010

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

8375 Dix Ellis Trl
Ste 201
Jacksonville, FL 32256
Phone (904) 399-5810

655 W 8th St
Fl 2
Jacksonville, FL 32209
Phone (904) 244-4202

3599 University Blvd S
Ste 300
Jacksonville, FL 32216
Phone (904) 348-3879

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

1350 13th Ave S
Jax Bch, FL 32250
Phone (904) 247-2900

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1900 Tebeau St
Ste C
Waycross, GA 31501

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1023213378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 N JEFFERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096525",
            "telephone_number": "904-470-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 N JEFFERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096525",
            "telephone_number": "904-470-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8375 Dix Ellis Trl Ste 201",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322568241",
            "country_code": "US",
            "telephone_number": "904-399-5550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENT",
        "first_name": "AMANDA",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "81349",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "OS13930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.