NPIMap

Organization Active NPI

Agape Community Health Center, Inc

Doing business as Agape Community Health Center, Inc- University

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
National Provider Identifier
1245695774
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
N04000004094 Issued in FL
Legal business name
AGAPE COMMUNITY HEALTH CENTER, INC
Doing business as
Agape Community Health Center, Inc- University
Agape Community Health Center, Inc. - South Jax
Practice address
3101 University Blvd S Ste 200
Jacksonville, FL 32216-2753
Phone
(904) 760-4904
Fax
(904) 647-2481
NPI assigned
Dec 29, 2015
Last updated
Sep 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Authorized official

Name
Ms. Mia L Jones
Title
Ceo
Phone
(904) 760-4904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X N04000004094 FL Primary

Addresses

Primary practice location

3101 University Blvd S Ste 200
Jacksonville, FL 32216-2753

Mailing address

120 King St
Jacksonville, FL 32204-2410
Phone (904) 760-4940

Other names 2

  • Agape Community Health Center, Inc- University Doing business as
  • Agape Community Health Center, Inc. - South Jax Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20050331000177 FL Part B Supplier - Clinic/Group Practice 3476500695 Receives reassigned benefits from 28 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL
O20170131000761 FL Part A Provider - Federally Qualified Health Center (FQHC) 3476500695 Practice locations: Jacksonville, FL
O20260126001207 FL Part A Provider - Federally Qualified Health Center (FQHC) 3476500695 Practice locations: Jacksonville, FL

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1245695774. Details of each certification follow.

Federally qualified health center certification: CCN 681080

Legal name
AGAPE COMMUNITY HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 31, 2017
Last certification
Jan 31, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 16, 2004 in FL
Enrollment address
3900 University Blvd S
Jacksonville, FL 32216-4331

Federally qualified health center certification: CCN C11072

Legal name
AGAPE COMMUNITY HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 23, 2026
Last certification
Jan 23, 2026
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
3101 University Blvd S
Ste 200
Jacksonville, FL 32216-2753

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

120 King St
Jacksonville, FL 32204
Phone (904) 800-6347

1680 Dunn Ave
Ste 3437
Jacksonville, FL 32218
Phone (904) 760-4964

1760 Edgewood Ave W
Jacksonville, FL 32208
Phone (904) 253-1030

5316 N Pearl St
Ste 18
Jacksonville, FL 32208

6138 Kennerly Rd
Jacksonville, FL 32216
Phone (904) 208-4120

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Mia Jones Individual Corporate OfficerCeo Apr 1, 2016
W-2 Managing Employee Apr 1, 2016
Corporate DirectorCeo Apr 1, 2016
W-2 Managing EmployeeAd; Apr 1, 2016
Operational/Managerial ControlCeo Apr 1, 2016

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1245695774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 KING ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322042410",
            "telephone_number": "904-760-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 UNIVERSITY BLVD S STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162753",
            "telephone_number": "904-760-4904",
            "fax_number": "904-647-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE COMMUNITY HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-29",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-760-4904",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "FL",
            "license": "N04000004094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agape Community Health Center, Inc- University",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Agape Community Health Center, Inc. - South Jax",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.