Tiara Funkhouser, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4600 Beach Blvd
Jacksonville, FL 32207-4764

Phone

(904) 650-3906

Fax

(904) 585-8240

NPI assigned

Jun 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tiara.funkhouser.1@12891.direct.athenahealth.com
• Direct secure messaging: tiara.funkhouser.1@25110.direct.athenahealth.com

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.

• Agape Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1962867762
  Medicare reassignment NPD (past)
• Agape Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1245695774
  NPD
• Agape Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1376178814
  NPD (past)
• Agape Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1578928826
  NPD (past)

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

{
    "created_epoch": "1656115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1306578786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074764",
            "telephone_number": "904-650-3906",
            "fax_number": "904-585-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074764",
            "telephone_number": "904-650-3906",
            "fax_number": "904-585-8240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 Hawthorn Ln",
            "address_purpose": "LOCATION",
            "city": "Saint Marys",
            "state": "GA",
            "postal_code": "315584028",
            "country_code": "US",
            "telephone_number": "904-650-3906",
            "fax_number": "904-585-8240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUNKHOUSER",
        "first_name": "TIARA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-25",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nairemis Fundora
• Gina Fungcharoen
• Kimberley Anne Funk, CCC-SLP
• Madison Kimble Funk, CRNA
• Zackary McKain Funk, MD
• Fups Dental, Inc.
• Paula Strange Fuqua, PHARM.D.
• Todd Nelson Furman, P.T.
• Jennifer Furones
• Laura Furtado Pessoa de Mendonca, MD

• Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.