NPIMap

Individual provider Active NPI

Carmella N Imig, M.D.

  • Family Medicine Physician
  • Gretna, NE
National Provider Identifier
1194823302
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20698 Issued in NE
Practice address
102 W Gruenther Rd
Gretna, NE 68028
Phone
(402) 332-2772
Fax
(402) 332-5446
NPI assigned
Sep 20, 2006
Last updated
Jul 31, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20698 NE Primary

Addresses

Primary practice location

102 W Gruenther Rd
Gretna, NE 68028

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311

Other practice location 1

818 Village Sq
Gretna, NE 68028-7914
Phone (402) 332-4559

Other practice location 2

818 Village Sq
Gretna, NE 68028-7914
Phone (402) 332-4559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20050920001011 NE Practitioner - Family Practice 7416943766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

102 W Gruenther Rd
Gretna, NE 68028-4828
Phone (402) 332-2772

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions37
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic Family Medicine CurrentSince Aug 1, 2019 Accepting new patients
Endless Journey Family Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients
The Wellness Place PC Family Medicine PastSince Jul 16, 2001 Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

102 W Gruenther Rd
Gretna, NE 68028
Phone (402) 332-2772

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

Interoperability endpoints

  • Direct secure messaging: cimig51138@achce.catholichealth.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Endless Journey LLCOmaha, NE, CCN 281519 Hospice Contracted Managing Employee Dec 31, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Endless Journey

    dba Endless Journey LLC

    • Community Based Hospice Care Agency
    • Omaha, NE
    • NPI 1073065033

    Contracted Managing Employee

    CMS ownership

Organizations & group practices 5

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 8

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1194823302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W GRUENTHER RD",
            "city": "GRETNA",
            "state": "NE",
            "postal_code": "68028",
            "telephone_number": "402-332-2772",
            "fax_number": "402-332-5446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "818 Village Sq",
            "address_purpose": "LOCATION",
            "city": "Gretna",
            "state": "NE",
            "postal_code": "680287914",
            "country_code": "US",
            "telephone_number": "402-332-4559",
            "fax_number": "402-332-4598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "818 Village Sq",
            "address_purpose": "LOCATION",
            "city": "Gretna",
            "state": "NE",
            "postal_code": "680287914",
            "country_code": "US",
            "telephone_number": "402-332-4559",
            "fax_number": "402-332-4598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMIG",
        "first_name": "CARMELLA",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "20698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, NE

Sources for this page

Verify at the official NPI Registry.