Active NPI
Carolyn Marie Misseou
- Home Health Agency
- Omaha, NE
National Provider Identifier
1497552228
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jul 20, 2025.
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Practice address
- 12180 Pedersen Dr
Omaha, NE 68144-4203 - Phone
- (402) 850-6943
- NPI assigned
- Feb 28, 2025
- 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 |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
12180 Pedersen Dr
Omaha, NE 68144-4203
Mailing address
11030 Q St
Omaha, NE 68137-3742
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740700800000",
"number": "1497552228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11030 Q ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681373742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12180 PEDERSEN DR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681444203",
"telephone_number": "402-850-6943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISSEOU",
"first_name": "CAROLYN",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-02-28",
"last_updated": "2025-02-28",
"certification_date": "2025-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.