Active NPI
James David Imbrock, M.D.
- Surgery Physician
- Omaha, NE
National Provider Identifier
1518050848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 13591
- Practice address
- 7710 Mercy Rd
Suite 309
Omaha, NE 68124-2372 - Phone
- (402) 399-9313
- Fax
- (402) 399-9314
- NPI assigned
- Sep 30, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 13591 | NE | Primary |
Addresses
Primary practice location
7710 Mercy Rd
Suite 309
Omaha, NE 68124-2372
Mailing address
7710 Mercy Rd
Suite 309
Omaha, NE 68124-2372
Phone (402) 399-9313
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00587 | Other | NE | BCBS NEBRASKA |
| 42-1158718-00 | Medicaid | NE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13591 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1518050848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7710 MERCY RD",
"address_2": "SUITE 309",
"city": "OMAHA",
"state": "NE",
"postal_code": "681242372",
"telephone_number": "402-399-9313",
"fax_number": "402-399-9314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7710 MERCY RD",
"address_2": "SUITE 309",
"city": "OMAHA",
"state": "NE",
"postal_code": "681242372",
"telephone_number": "402-399-9313",
"fax_number": "402-399-9314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMBROCK",
"first_name": "JAMES",
"middle_name": "DAVID",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NE",
"license": "13591",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NEBRASKA",
"identifier": "00587",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42-1158718-00",
"state": "NE"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.