NPIMap

Individual provider Active NPI

Carleigh B Golden, M.D.

  • Internal Medicine Physician
  • Omaha, NE
National Provider Identifier
1174905996
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30613 Issued in NE
Practice address
5002 Underwood Ave
Omaha, NE 68132
Phone
(402) 717-0785
Fax
(402) 717-4905
NPI assigned
Jun 29, 2015
Last updated
Sep 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 7479 NE
Internal Medicine Physician 207R00000X 30613 NE Primary

Addresses

Primary practice location

5002 Underwood Ave
Omaha, NE 68132

Mailing address

5002 Underwood Ave Dept of
Omaha, NE 68132-2236
Phone (402) 717-0785

Other names 1

  • Carleigh B Koenck Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231130003054 IA Practitioner - Internal Medicine 3274815733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Creighton University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

201 Ridge St
Suite 312
Council Bluffs, IA 51503-4643
Phone (402) 354-1530

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7479NEMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital Current Accepting new patients
Physicians Clinic Inc Internal Medicine CurrentSince Dec 31, 2023 Accepting new patients
Alegent Creighton Clinic Internal Medicine Past Accepting new patients

Locations

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

1 Edmundson Pl
Ste 310
Council Bluffs, IA 51503
Phone (712) 328-1801

201 Ridge St
Ste 312
Council Bluffs, IA 51503
Phone (402) 815-1970

825 S 169th St
Fl 3
Omaha, NE 68118
Phone (402) 354-5451

Interoperability endpoints

  • Direct secure messaging: carleigh.golden@direct.nmhs.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1174905996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 UNDERWOOD AVE DEPT OF",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681322236",
            "telephone_number": "402-717-0785",
            "fax_number": "402-717-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 UNDERWOOD AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68132",
            "telephone_number": "402-717-0785",
            "fax_number": "402-717-4905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDEN",
        "first_name": "CARLEIGH",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "7479",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "30613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLEIGH",
            "last_name": "KOENCK",
            "middle_name": "B",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.