Individual provider Active NPI

Katherine Rose Imig

  • Speech-Language Pathologist
  • Red Oak, IA
National Provider Identifier
1003489360
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
109486 Issued in IA
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

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 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

Enrollment IDStateProvider typePAC IDDetails
I20231213003708 NE Practitioner - Qualified Speech Language Pathologist 8022467240 Reassigns benefits to 1 organization

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
Rehabvisions Therapy NE LLCGroup PAC ID 8224378617, 20 clinicians

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

LicenseStateTypeSpecialty
2591NEMDMental Health Counselor
109486IAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabvisions Therapy NE, LLC Speech-Language Pathologist CurrentSince Jan 7, 2024 Accepting new patients
Rehabvisions Therapy NE, LLC CurrentSince Jan 7, 2024 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.

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.

Verify at the official NPI Registry.