Individual provider Active NPI

Kwesi Lee Koranteng Immanuel, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Casa Grande, AZ
National Provider Identifier
1952267775
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
254947 Issued in AZ
Practice address
818 E Wiley Way
Casa Grande, AZ 85122-1218
Phone
(520) 371-0846
NPI assigned
Dec 26, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 254947 AZ Primary

Addresses

Primary practice location

818 E Wiley Way
Casa Grande, AZ 85122-1218

Mailing address

818 E Wiley Way
Casa Grande, AZ 85122-1218
Phone (520) 371-0846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
254947AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Good Wellness PLLC Single Specialty Current Accepting new patients

Organizations & group practices 1

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": "1766707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1952267775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 E WILEY WAY",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851221218",
            "telephone_number": "520-371-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 E WILEY WAY",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851221218",
            "telephone_number": "520-371-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMMANUEL",
        "first_name": "KWESI",
        "middle_name": "LEE KORANTENG",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-26",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "254947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.