Jonathan C Gogol, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024183300 Issued in VA

Practice address

416 3Rd St Ste D
Petersburg, VA 23803-3300

Phone

(804) 653-7009

Fax

(804) 773-4688

NPI assigned

May 2, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Revive Behavioral HealthGroup PAC ID 8729516125, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Revive Behavioral Health

  • Behavioral Neurology & Neuropsychiatry Physician
  • Petersburg, VA
  • NPI 1942055504

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Otl Community Services

  • Professional Counselor
  • North Chesterfield, VA
  • NPI 1679871784

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1437894748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 3RD ST STE D",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238033300",
            "telephone_number": "804-653-7009",
            "fax_number": "804-773-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 3RD ST STE D",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238033300",
            "telephone_number": "804-653-7009",
            "fax_number": "804-773-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOGOL",
        "first_name": "JONATHAN",
        "middle_name": "C",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-02",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024183300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rajwinder Singh Gill, M.D.
• Madison Gillard, PA-C
• Rachel R. Gillus, LPC
• Sonya Gittelman, L.C.S.W.
• Gnus Corporation
• Golden Physician Partners, LLC
• Golden Physician Partners, LLC
• Golden Physician Partners, LLC
• Manuel Borja Gonzales, M.D.
• Sarah Goolsby, DPT

• Psychiatric/Mental Health Nurse Practitioner in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.