904 Health, Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

904 HEALTH, INC

Practice address

96040 Lofton Square CT
Yulee, FL 32097-6347

Phone

(904) 659-2475

Fax

(904) 453-8600

NPI assigned

Dec 21, 2022

Organization subpart

No

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

Authorized official

Name

Wendy Kelly

Title

Office Administrator

Phone

(563) 650-2158

Specialties & licenses 4

Addresses

Other names 1

• Manager Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• 904 Health, Inc

  • Infectious Disease Physician
  • Jacksonville, FL
  • NPI 1184305435
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Blessing Inyang

  • General Practice Physician
  • Jacksonville, FL
  • NPI 1558984369
  NPD (past)
• Robyn Reaves

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1396291936
  NPD (past)
• Gwendolyn Flonnery-Roberts, MSN, FNP-C, AAHIVS

  • Family Nurse Practitioner
  • Brunswick, GA
  • NPI 1487057758
  NPD (past)

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1699487678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 N HOGAN ST STE 118",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322024201",
            "telephone_number": "904-659-2475",
            "fax_number": "904-453-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96040 LOFTON SQUARE CT",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320976347",
            "telephone_number": "904-659-2475",
            "fax_number": "904-453-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2420 S Highway 29",
            "address_purpose": "LOCATION",
            "city": "Cantonment",
            "state": "FL",
            "postal_code": "325335808",
            "country_code": "US",
            "telephone_number": "904-900-1513",
            "fax_number": "904-575-4944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3574 US 1 S Ste 101-104",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320866466",
            "country_code": "US",
            "telephone_number": "904-900-1513",
            "fax_number": "904-575-4944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1241 Blanding Blvd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320655908",
            "country_code": "US",
            "telephone_number": "904-900-1513",
            "fax_number": "904-575-4944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4427 Emerson St Ste A",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322074969",
            "country_code": "US",
            "telephone_number": "904-900-1513",
            "fax_number": "904-575-4944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "320 Oakfield Dr",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335115723",
            "country_code": "US",
            "telephone_number": "904-900-1513",
            "fax_number": "904-575-4944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1104 E Fowler Ave Unit 100",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336125404",
            "country_code": "US",
            "telephone_number": "904-900-1513",
            "fax_number": "904-575-4944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7207 N Nebraska Ave",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336044916",
            "country_code": "US",
            "telephone_number": "904-904-1513",
            "fax_number": "904-575-4944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5951 Clark Center Ave Unit B",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342382717",
            "country_code": "US",
            "telephone_number": "904-900-1513",
            "fax_number": "904-575-4944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2102 14th St W",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342056351",
            "country_code": "US",
            "telephone_number": "904-900-1513",
            "fax_number": "904-575-4944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1823 Business Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321141230",
            "country_code": "US",
            "telephone_number": "904-900-1513",
            "fax_number": "904-575-4944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "57 Town Ct Ste 215",
            "address_purpose": "LOCATION",
            "city": "Palm Coast",
            "state": "FL",
            "postal_code": "321642425",
            "country_code": "US",
            "telephone_number": "904-900-1513",
            "fax_number": "904-575-4944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "904 HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-21",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "563-650-2158"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manager",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Manager",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amy Marie Abernathy
• Kalli A Ackerman, APRN
• Carolyn E Adams, RRT
• Chisara Adonai, MD
• Peter Agdamag Jr.

• Primary Care Clinic/Center in Yulee, FL
• Providers in Yulee, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.