TAMMY SUE WALL (LMSW) – Social Worker, NPI 1154903870

TAMMY SUE WALL (LMSW) is a healthcare provider. based in Coeur d alene, Idaho. specializing in UNDEFINED NON-PHYSICIAN TYPE (SPECIFY). They hold the professional credentials LMSW. They hold a License No. LMSW34849 (ID). The NPI Number for TAMMY SUE WALL (LMSW) is 1154903870

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
TAMMY SUE WALL (LMSW)
NPI
1154903870
Phone
(208) 625-5311
Address
2003 KOOTENAI HEALTH WAY
Enumeration Date
22 April 2021
Last Update Date
25 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2086254900
Graduation Year
2015 (11 years ago)
PAC ID
6507275179
Group Practice PAC ID
1355792276
Professional Enrollment ID
I20210511003075
Address ID
ID838549064PO1440XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness85
Years active:5State licenses:1Digital endpointsOther names

13 UNDEFINED NON-PHYSICIAN TYPE (SPECIFY) in ID

Provider Addresses for TAMMY SUE WALL (LMSW)

  • 2003 KOOTENAI HEALTH WAY

    COEUR D ALENE, ID 838146051

    Phone: (208) 625-5311

    Fax: (208) 625-4184

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-05-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210511003075ISocial WorkerIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83814)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355792276View full group profile
NameSpecialtyState
Orthopedic SurgeryID
Physician AssistantID
Surgical Oncology, Hematology/Oncology, General SurgeryWA
Pulmonary Disease, Critical Care (Intensivists)ID
Physician AssistantID
Physician AssistantUT
Certified Nurse Midwife (Cnm)ID
Physician AssistantID
Internal MedicineTX
Nephrology, Internal MedicineWA

Reviews

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Frequently asked questions

What is the registry number for TAMMY SUE WALL (LMSW)?
The registry entry for TAMMY SUE WALL (LMSW) shows NPI 1154903870.
Should I treat TAMMY SUE WALL (LMSW) as an active provider?
Patients and plans typically see TAMMY SUE WALL (LMSW) as active in the national extract.
What type of care does TAMMY SUE WALL (LMSW) provide?
TAMMY SUE WALL (LMSW)'s profile centers on Social Worker. Clinical services aligned with this taxonomy classification.
Can patients visit TAMMY SUE WALL (LMSW) in Coeur D Alene, Idaho?
For routing, start with Coeur D Alene, Idaho for TAMMY SUE WALL (LMSW), then verify phone and hours locally.
Who maintains TAMMY SUE WALL (LMSW)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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