Individual provider Active NPI

Autumn J Agbaza, FNP-BC

  • Family Nurse Practitioner
  • Nashville, TN
National Provider Identifier
1730840299
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71012160A Issued in IN
Practice address
501 Great Circle Rd
Nashville, TN 37228-1317
Phone
(615) 436-9060
Fax
(615) 235-9725
NPI assigned
Jan 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 21220818A IN
Family Nurse Practitioner 363LF0000X 71012160A IN Primary

Addresses

Primary practice location

501 Great Circle Rd
Nashville, TN 37228-1317

Mailing address

PO Box 637764
Cincinnati, OH 45263-7764
Phone (317) 880-3939

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address autumn.agbaza@237407481626628.direct.elationemr.com Direct CareBridge Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-5045

720 Eskeanzi Ave
Indianapolis, IN 46202-5166

720 Eskenazi Ave
Indianapolis, IN 46202-5187

PO Box 772 - MC
Woonsocket, RI 02895-0784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21220818AINMDRegistered Nurse
71012160AINMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1730840299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637764",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452637764",
            "telephone_number": "317-880-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GREAT CIRCLE RD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281317",
            "telephone_number": "615-436-9060",
            "fax_number": "615-235-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGBAZA",
        "first_name": "AUTUMN",
        "middle_name": "J",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-06",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "21220818A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012160A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "autumn.agbaza@237407481626628.direct.elationemr.com",
            "affiliation": "Y",
            "endpointDescription": "Carebridge Medical Group",
            "affiliationName": "CareBridge Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "501 Great Circle Rd",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372281317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.