Individual provider Active NPI

Gostine Dankwa, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1336683440
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10002296APRN Issued in OR
Practice address
633 E Ray Rd Ste 130
Gilbert, AZ 85296-4206
Phone
(832) 819-4378
Fax
(253) 954-3116
NPI assigned
Dec 8, 2016
Last updated
Dec 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60808469 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP132780 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10002296APRN OR Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 10002296RN OR

Addresses

Primary practice location

633 E Ray Rd Ste 130
Gilbert, AZ 85296-4206

Mailing address

14135 Sundial Stone LN
Cypress, TX 77429-1100
Phone (614) 804-0635

Other practice location 1

14135 Sundial Stone Ln
Cypress, TX 77429-1100
Phone (614) 804-0635

Other identifiers 2

IdentifierTypeStateIssuer
500814953MedicaidOR
13945105OtherCAQH ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR, AZ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20211213001392 WA Practitioner - Nurse Practitioner 6901188028 Reassigns benefits to 2 organizations
I20230215001426 OR Practitioner - Nurse Practitioner 6901188028 Reassigns benefits to 3 organizations
I20240903002596 AZ Practitioner - Nurse Practitioner 6901188028 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
Group practices
Amber Benson Pmhnp PCGroup PAC ID 3072786755, 24 clinicians

Practice addresses (Care Compare)

2600 Ctr St NE
Salem, OR 97301-2669
Phone (503) 945-2800

66 Club Rd
Suite 160
Eugene, OR 97401-2439
Phone (541) 345-1722

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10002296RNORMDPsychiatric/Mental Health Registered Nurse
10002296APRNORMDPsychiatric/Mental Health Nurse Practitioner
AP132780TXMDPsychiatric/Mental Health Nurse Practitioner
AP60808469WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ultimate Psychiatry PLLC Multi-Specialty CurrentSince Jul 1, 2024 Accepting new patients
Multicare Health System Multi-Specialty CurrentSince Aug 25, 2021 Accepting new patients
Navos Multi-Specialty CurrentSince Aug 25, 2021 Accepting new patients
Navos Multi-Specialty Current Accepting new patients
Multicare Health System CurrentSince Aug 25, 2021 Accepting new patients
Multicare Health System Multi-Specialty Current Accepting new patients
DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P Multi-Specialty CurrentSince Sep 20, 2024 Accepting new patients
Ultimate Professional Services Multi-Specialty CurrentSince May 15, 2023 Accepting new patients
Amber Benson Pmhnp PC Multi-Specialty CurrentSince Feb 2, 2023 Accepting new patients
Ultimate Professional Mental Health Services Corp Multi-Specialty PastSince Feb 1, 2023 Accepting new patients

Locations

633 E Ray Rd
Ste 130
Gilbert, AZ 85296
Phone (480) 562-0274

66 Club Rd
Ste 160
Eugene, OR 97401
Phone (541) 345-1722

216 Commercial St NE
Salem, OR 97301
Phone (614) 804-0635

2600 Center St NE
Salem, OR 97301
Phone (503) 945-2800

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

2600 SW Holden St
Seattle, WA 98126
Phone (206) 241-0990

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1336683440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14135 SUNDIAL STONE LN",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774291100",
            "telephone_number": "614-804-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 E RAY RD STE 130",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964206",
            "telephone_number": "832-819-4378",
            "fax_number": "253-954-3116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14135 Sundial Stone Ln",
            "address_purpose": "LOCATION",
            "city": "Cypress",
            "state": "TX",
            "postal_code": "774291100",
            "country_code": "US",
            "telephone_number": "614-804-0635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANKWA",
        "first_name": "GOSTINE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-08",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60808469",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP132780",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10002296APRN",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10002296RN",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500814953",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "13945105",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.