Active NPI
Ndaizeye Immaculee
- Contractor
- Omaha, NE
National Provider Identifier
1982313086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- H13603076
- Practice address
- 4312 Burdette St
Omaha, NE 68111-3911 - Phone
- (402) 804-9568
- NPI assigned
- Nov 16, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Contractor | 171W00000X | H13603076 | NE | Primary |
Addresses
Primary practice location
4312 Burdette St
Omaha, NE 68111-3911
Mailing address
4312 Burdette St
Omaha, NE 68111-3911
Phone (402) 804-9568
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H13603076 | Other | NE | DRIVER'S LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H13603076 | NE | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668556800000",
"number": "1982313086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4312 BURDETTE ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681113911",
"telephone_number": "402-804-9568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4312 BURDETTE ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681113911",
"telephone_number": "402-804-9568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMMACULEE",
"first_name": "NDAIZEYE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-16",
"last_updated": "2022-11-16",
"certification_date": "2022-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "NE",
"license": "H13603076",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER'S LICENSE",
"identifier": "H13603076",
"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 Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.