Individual provider Active NPI

Christine Mamphey Dankwa, M.D., M.P.H

  • Pediatrics Physician
  • Elkhart, IN
National Provider Identifier
1548412000
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01070358A Issued in IN
Practice address
236 Simpson Ave
Elkhart, IN 46516-4666
Phone
(574) 293-0052
Fax
(514) 970-3256
NPI assigned
Oct 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301092714 MI
Pediatrics Physician 208000000X 01070358A IN Primary
Pediatrics Physician 208000000X 036.128761 IL

Addresses

Primary practice location

236 Simpson Ave
Elkhart, IN 46516-4666

Mailing address

236 Simpson Ave
Elkhart, IN 46516-4666
Phone (574) 293-0052

Other identifiers 1

IdentifierTypeStateIssuer
201038510AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260325003573 IN Practitioner - Pediatric Medicine 1456836659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

236 Simpson Ave
Elkhart, IN 46516-4666

9425 Delegates Row
Indianapolis, IN 46240-3805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.128761ILMDPediatrics Physician
01070358AINMDPediatrics Physician
4301092714MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heart City Health Center Pharmacy Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: christine.dankwa.1@11397.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1548412000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 SIMPSON AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465164666",
            "telephone_number": "574-293-0052",
            "fax_number": "514-970-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 SIMPSON AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465164666",
            "telephone_number": "574-293-0052",
            "fax_number": "514-970-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANKWA",
        "first_name": "CHRISTINE",
        "middle_name": "MAMPHEY",
        "credential": "M.D., M.P.H",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-16",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301092714",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01070358A",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.128761",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201038510A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.