Organization Active NPI

Cawab Medical LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1891321790
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
CAWAB MEDICAL LLC
Practice address
11060 Oak St Ste 6
Omaha, NE 68144-4244
Phone
(402) 889-3633
Fax
(531) 375-3755
NPI assigned
Mar 23, 2020
Last updated
Aug 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Authorized official

Name
Kimbelry K Anderson, PMHNP
Title
Owner
Phone
(402) 889-3633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

11060 Oak St Ste 6
Omaha, NE 68144-4244

Mailing address

11060 Oak St Ste 6
Omaha, NE 68144-4244
Phone (402) 889-3633

Other identifiers 1

IdentifierTypeStateIssuer
1124062161MedicaidNE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755043200000",
    "number": "1891321790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11060 OAK ST STE 6",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681444244",
            "telephone_number": "402-889-3633",
            "fax_number": "531-375-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11060 OAK ST STE 6",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681444244",
            "telephone_number": "402-889-3633",
            "fax_number": "531-375-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAWAB MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-23",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "KIMBELRY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-889-3633",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124062161",
            "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 Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.