Agape Family Healthcare Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

AGAPE FAMILY HEALTHCARE CLINIC

Practice address

1124 Whitehall St
Jackson, TN 38301-8742

Phone

(731) 616-4468

NPI assigned

Jan 4, 2012

Last updated

Jan 4, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cynthia Early, FNP CNMNPI 1881644862

Title

Family Nurse Practitioner

Phone

(731) 616-4468

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

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.

• Cynthia A Early, FNP

  • Family Nurse Practitioner
  • Jackson, TN
  • NPI 1881644862
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1083984298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2156 N HIGHLAND AVE # B108",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383054915",
            "telephone_number": "731-616-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 WHITEHALL ST",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383018742",
            "telephone_number": "731-616-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE FAMILY HEALTHCARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-04",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "EARLY",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "731-616-4468",
        "authorized_official_credential": "FNP CNM"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Jackson, TN
• Providers in Jackson, TN by specialty
• Primary Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.