Individual provider Active NPI

Dina Marie Gibson, FNP

  • Family Nurse Practitioner
  • Sun City, AZ
National Provider Identifier
1063998912
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP11376 Issued in AZ
Practice address
13640 N 99TH Ave
Sun City, AZ 85351-2866
Phone
(623) 972-2116
Fax
(623) 972-0521
NPI assigned
Jul 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP11376 AZ Primary

Addresses

Primary practice location

13640 N 99TH Ave
Sun City, AZ 85351-2866

Mailing address

3260 N Hayden Rd Ste 112
Scottsdale, AZ 85251-6650
Phone (602) 264-9100

Other practice location 1

14869 W Bell Rd Ste 100
Surprise, AZ 85374-7608
Phone (623) 972-2116

Other practice location 2

9836 W Yearling Rd # F1300-B
Peoria, AZ 85383-1376
Phone (623) 972-2116

Other identifiers 1

IdentifierTypeStateIssuer
462066MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20180905001679 AZ Practitioner - Nurse Practitioner 1557611902 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arizona Digestive Health PCGroup PAC ID 6507940731, 134 clinicians

Practice addresses (Care Compare)

13640 N 99TH Ave
Suite 600
Sun City, AZ 85351-2867
Phone (623) 972-2116

Hospital & facility affiliations

  • Banner Boswell Medical Center Hospital, Sun City, AZ, CCN 030061

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Super Specialists LLC CurrentSince Mar 1, 2023 Accepting new patients
Az Care Anesthesia , PLC CurrentSince Jul 1, 2018 Accepting new patients

Locations

755 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 271-5111

1441 N 12th St
Fl 2
Phoenix, AZ 85006
Phone (602) 521-5180

1441 N 12th St
Fl 3
Phoenix, AZ 85006
Phone (602) 521-5700

13640 N 99th Ave
Ste 600
Sun City, AZ 85351
Phone (623) 523-0580

Organizations & group practices 3

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

Hospital & facility affiliations 1

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": "1531440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1063998912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 N HAYDEN RD STE 112",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516650",
            "telephone_number": "602-264-9100",
            "fax_number": "602-264-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13640 N 99TH AVE",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853512866",
            "telephone_number": "623-972-2116",
            "fax_number": "623-972-0521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14869 W Bell Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853747608",
            "country_code": "US",
            "telephone_number": "623-972-2116",
            "fax_number": "623-972-0521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9836 W Yearling Rd # F1300-B",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853831376",
            "country_code": "US",
            "telephone_number": "623-972-2116",
            "fax_number": "623-972-0521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "DINA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-13",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "462066",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

Verify at the official NPI Registry.