NPIMap

Organization Active NPI

Agape Family Health, LLC

  • Rural Health Clinic/Center
  • Columbia, TN
National Provider Identifier
1073066205
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
AGAPE FAMILY HEALTH, LLC
Practice address
915 S Garden St
Columbia, TN 38401-3205
Phone
(931) 548-8090
Fax
(931) 548-8110
NPI assigned
Jul 23, 2016
Last updated
Jul 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Authorized official

Name
Katherine RingNPI 1740669191
Title
Owner/Nurse Practitioner
Phone
(931) 797-2365

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

915 S Garden St
Columbia, TN 38401-3205

Mailing address

915 S Garden St
Columbia, TN 38401-3205
Phone (931) 548-8090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170220002352 TN Part B Supplier - Clinic/Group Practice 3072896943 Receives reassigned benefits from 11 practitioners
Practice locations: Columbia, TN
O20210802002250 TN Part A Provider - Rural Health Clinic 3072896943 Practice locations: Columbia, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073066205. Details of each certification follow.

Rural health clinic certification: CCN 883855

Legal name
AGAPE FAMILY HEALTH, LLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 7, 2021
Last certification
Dec 7, 2021
Ownership / control type
1C
Organization structure
LLCProprietary
Enrollment address
915 S Garden St
Columbia, TN 38401-3205

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2121842Agape Family Health, LLC915 South Garden Street, Columbia, TN 38401Certificate of waiverNov 14, 2026

National Provider Directory

National Provider Directory

Locations

1501 Hatcher Ln
Ste A
Columbia, TN 38401
Phone (931) 548-8090

915 S Garden St
Columbia, TN 38401
Phone (931) 548-8090

915 S Garden St
Ste 1
Columbia, TN 38401

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24835/brand/1/csg/1/fhir/r4

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Katherine Ring Individual 5% Or Greater Direct Ownership Interest Jul 6, 2021 50%
Corporate OfficerPresident Jul 6, 2021 50%
Operational/Managerial ControlPresident Jul 6, 2021 50%
Jamie Ring Individual Corporate OfficerSecretary Jul 6, 2021 50%
Operational/Managerial ControlSecretary Jul 6, 2021 50%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1469232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1073066205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 S GARDEN ST",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384013205",
            "telephone_number": "931-548-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 S GARDEN ST",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384013205",
            "telephone_number": "931-548-8090",
            "fax_number": "931-548-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE FAMILY HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-23",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "RING",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "931-797-2365"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

Verify at the official NPI Registry.