Healthcare Provider Details

I. General information

NPI: 1144727314
Provider Name (Legal Business Name): MICHEALA MCCARTHY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8005 FARNAM DR STE 305
OMAHA NE
68114-3426
US

IV. Provider business mailing address

8005 FARNAM DR STE 305
OMAHA NE
68114-3426
US

V. Phone/Fax

Practice location:
  • Phone: 402-390-4111
  • Fax: 402-390-4115
Mailing address:
  • Phone: 402-390-4111
  • Fax: 402-390-4115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number36334
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number36334
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: