Organization Active NPI

Agape Health & Wellness Center Inc.

  • Community/Behavioral Health Agency
  • Jacksonville, FL
National Provider Identifier
1386223469
Registry record updated Aug 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
AGAPE HEALTH & WELLNESS CENTER INC.
Practice address
11555 Central Pkwy Ste 601
Jacksonville, FL 32224-2698
Phone
(904) 619-6715
Fax
(904) 297-2266
NPI assigned
Apr 6, 2021
Last updated
Aug 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2026

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

Authorized official

Name
Erakal Goodman, MD
Title
Ceo
Phone
(904) 619-6715

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Mental Health Counselor 101YM0800X NU
Case Management Agency 251B00000X NU
Home Health Agency 251E00000X NU
Community/Behavioral Health Agency 251S00000X NU Primary
Health Educator 174H00000X NU

Addresses

Primary practice location

11555 Central Pkwy Ste 601
Jacksonville, FL 32224-2698

Mailing address

11555 Central Pkwy Ste 601
Jacksonville, FL 32224-2698
Phone (904) 619-6715

Other practice location 1

6817 Southpoint Pkwy Ste 1201
Jacksonville, FL 32216-6296
Phone (904) 661-1592

Other identifiers 1

IdentifierTypeStateIssuer
125235000MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231023001440 FL Part B Supplier - Clinic/Group Practice 0547616815 Receives reassigned benefits from 2 practitioners
Practice locations: Jacksonville, FL

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
10D2283912Agape Health & Wellness Center, Inc11555 Central Pkwy - Ste 601, Jacksonville, FL 32224Certificate of waiverJun 13, 2027

National Provider Directory

National Provider Directory

Locations

11555 Central Pkwy
Ste 601
Jacksonville, FL 32224
Phone (904) 559-9071

6138 Kennerly Rd
Ste AND150
Jacksonville, FL 32216
Phone (386) 283-2010

6138 Kennerly Rd
Unit 150
Jacksonville, FL 32216
Phone (904) 619-6715

Practitioners & affiliated clinicians

Practitioners 3

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": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786752000000",
    "number": "1386223469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11555 CENTRAL PKWY STE 601",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242698",
            "telephone_number": "904-619-6715",
            "fax_number": "904-297-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 CENTRAL PKWY STE 601",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242698",
            "telephone_number": "904-619-6715",
            "fax_number": "904-297-2266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6817 Southpoint Pkwy Ste 1201",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322166296",
            "country_code": "US",
            "telephone_number": "904-661-1592",
            "fax_number": "904-297-2266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AGAPE HEALTH & WELLNESS CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2026-08-15",
        "certification_date": "2026-08-15",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "ERAKAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-619-6715",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125235000",
            "state": "FL"
        }
    ],
    "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 Aug 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.