Active NPI
Katherine Rose Imig
- Speech-Language Pathologist
- Red Oak, IA
National Provider Identifier
1003489360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 109486
- Practice address
- 2301 Eastern Ave
Red Oak, IA 51566-1300 - Phone
- (712) 623-7000
- NPI assigned
- Jul 22, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 109486 | IA | Primary |
Addresses
Primary practice location
2301 Eastern Ave
Red Oak, IA 51566-1300
Mailing address
2301 Eastern Ave
Red Oak, IA 51566-1305
Phone (712) 623-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11623 Arbor St
Omaha, NE 68144-2981
Phone (402) 334-1919
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2591 | NE | MD | Mental Health Counselor |
| 109486 | IA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabvisions Therapy NE, LLC | Speech-Language Pathologist | Current | Accepting new patients |
| Rehabvisions Therapy NE, LLC | Current | Accepting new patients |
Locations
2001 Westown Pkwy
Ste 104
West Des Moines, IA 50265
Phone (402) 334-6063
11623 Arbor St
Omaha, NE 68144
Phone (402) 334-1919
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.
-
- Physical Therapist
- Dickinson, ND
- NPI 1720791361
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626912000000",
"number": "1003489360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 EASTERN AVE",
"city": "RED OAK",
"state": "IA",
"postal_code": "515661305",
"telephone_number": "712-623-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 EASTERN AVE",
"city": "RED OAK",
"state": "IA",
"postal_code": "515661300",
"telephone_number": "712-623-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMIG",
"first_name": "KATHERINE",
"middle_name": "ROSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-22",
"last_updated": "2021-07-22",
"certification_date": "2021-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "IA",
"license": "109486",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Red Oak, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.