JAMES RANDALL BOLTON (LISW) – Clinical Social Worker, NPI 1053452243
Clinical Social Worker
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
827 CLINICAL SOCIAL WORKER in IA
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Provider Addresses for JAMES RANDALL BOLTON (LISW)
1441, West Central Park Avenue, Davenport, Scott County, Iowa, 52804, United States
DAVENPORT, IA 528041707
Phone: (563) 888-6275
Fax: (563) 884-4638
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.
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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: 2008-06-13
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080613000315 | I | Clinical Social Worker | IA | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90834 | Psychotherapy, 45 minutes | 278 | 26 | $0 |
| 90791 | Psychiatric diagnostic evaluation | 12 | 12 | $0 |
Insurance plans in this area (ZIP 52804)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IA | |
| Clinical Social Worker | IA | |
| Nurse Practitioner | IA | |
| Nurse Practitioner | IA | |
| Clinical Social Worker | IA | |
| - | IA | |
| Clinical Social Worker | IA | |
| Mental Health Counselor | MA | |
| Nurse Practitioner | IL | |
| Clinical Social Worker | IA |
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