Individual provider Active NPI

Diana Exornam Amenya, APRN

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1396281028
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9269280 Issued in FL
Practice address
1301 Palm Ave
Jacksonville, FL 32207-8432
Phone
(904) 202-7300
Fax
(904) 202-2754
NPI assigned
Jan 19, 2017
Last updated
Apr 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN9269280 FL Primary
Acute Care Nurse Practitioner 363LA2100X 9269280 FL
Adult Health Nurse Practitioner 363LA2200X APRN9269280 FL

Addresses

Primary practice location

1301 Palm Ave
Jacksonville, FL 32207-8432

Mailing address

PO Box 746654
Atlanta, GA 30374-6654
Phone (904) 202-2092

Other names 1

  • Miss Diana Exornam Agboada-Jones Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170727001790 FL Practitioner - Nurse Practitioner 5294005096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist MD Anderson Cancer Physicians IncGroup PAC ID 5991932063, 115 clinicians

Practice addresses (Care Compare)

1301 Palm Ave
Jacksonville, FL 32207-8432
Phone (904) 202-7300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.84 of 100Reported as group
Quality
73.65
Promoting interoperability
100
Improvement activities
40
Cost
74.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9269280FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist MD Anderson Cancer Physicians Inc CurrentSince Feb 20, 2023 Accepting new patients
Baptist MD Anderson Cancer Physicians Inc PastSince Dec 1, 2023 Accepting new patients

Locations

1301 Palm Ave
Jacksonville, FL 32207
Phone (844) 632-2278

1301 Palm Ave
Ste 700
Jacksonville, FL 32207

14546 Old Saint Augustine Rd
Ste 105
Jacksonville, FL 32258
Phone (904) 271-6890

Interoperability endpoints

  • Direct secure messaging: dagbodajones134790@baptisthealthsystemjacksonville.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1396281028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746654",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746654",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PALM AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078432",
            "telephone_number": "904-202-7300",
            "fax_number": "904-202-2754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMENYA",
        "first_name": "DIANA",
        "middle_name": "EXORNAM",
        "name_prefix": "Miss",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-19",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9269280",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "9269280",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9269280",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "AGBOADA-JONES",
            "middle_name": "EXORNAM",
            "prefix": "MISS",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.