NPIMap

Organization Active NPI

Agape Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
National Provider Identifier
1326668351
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
AGAPE COMMUNITY HEALTH CENTER, INC
Practice address
1680 Dunn Ave Ste 38B
Jacksonville, FL 32218-4744
Phone
(904) 760-4904
NPI assigned
Apr 20, 2020
Last updated
Nov 3, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
AGAPE COMMUNITY HEALTH CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Authorized official

Name
Mia Fussel
Title
Chief Operating Officer
Phone
(904) 800-6347

Specialties & licenses 1

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

Addresses

Primary practice location

1680 Dunn Ave Ste 38B
Jacksonville, FL 32218-4744

Mailing address

1680 Dunn Ave Ste 38B
Jacksonville, FL 32218-4744
Phone (904) 760-4904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

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

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
Tax ID family
Agape Community Health Center Inc13 organizations share this tax ID, including this one
Part of
Agape Community Health Center Inc

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1680 Dunn Ave
Ste 35
Jacksonville, FL 32218
Phone (904) 714-9053

1680 Dunn Ave
Ste 38A
Jacksonville, FL 32218

5460 Blanding Blvd
Jacksonville, FL 32244
Phone (904) 800-6347

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762128000000",
    "number": "1326668351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 DUNN AVE STE 38B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184744",
            "telephone_number": "904-760-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 DUNN AVE STE 38B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184744",
            "telephone_number": "904-760-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE COMMUNITY HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AGAPE COMMUNITY HEALTH CENTER, INC",
        "enumeration_date": "2020-04-20",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A",
        "authorized_official_last_name": "FUSSEL",
        "authorized_official_first_name": "MIA",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "904-800-6347"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; 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.