KATHERINE ANN DEWALL – Clinical Social Worker, NPI 1174033245

KATHERINE ANN DEWALL is a healthcare provider. based in Davenport, Iowa. specializing in CLINICAL SOCIAL WORKER. The NPI Number for KATHERINE ANN DEWALL is 1174033245

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
KATHERINE ANN DEWALL
NPI
1174033245
Phone
Not provided
Address
1441 W CENTRAL PARK AVE
Enumeration Date
3 October 2017
Last Update Date
3 October 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7124643171
Graduation Year
2013 (13 years ago)
PAC ID
2769744887
Group Practice PAC ID
4486563707
Professional Enrollment ID
I20180412002398
Address ID
IA514491585LA1301XSTXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness75
Years active:8State licenses:0Digital endpointsOther names

827 CLINICAL SOCIAL WORKER in IA

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Provider Addresses for KATHERINE ANN DEWALL

  • 1441, West Central Park Avenue, Davenport, Scott County, Iowa, 52804, United States

    DAVENPORT, IA 528041707

    Phone:

    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: 2018-04-12

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
I20180412002398IClinical Social WorkerIATBD

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 52804)

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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: 4486563707View full group profile
NameSpecialtyState
General SurgeryMO
Emergency MedicineIA
Nurse PractitionerIA
Physician AssistantIA
Nurse PractitionerIA
Nurse PractitionerIA
General SurgeryIA
-IL
Physician AssistantIA
Physician AssistantIA

Reviews

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Frequently asked questions

What is KATHERINE ANN DEWALL's NPI number?
KATHERINE ANN DEWALL's NPI is 1174033245 — the number used across U.S. healthcare to identify this provider.
Would KATHERINE ANN DEWALL appear as active to a payer?
You can treat KATHERINE ANN DEWALL as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to KATHERINE ANN DEWALL?
KATHERINE ANN DEWALL's specialty line reads Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What locale is associated with KATHERINE ANN DEWALL?
Directory geography for KATHERINE ANN DEWALL centers on Davenport, Iowa.
When was this NPI issued?
Enumeration for KATHERINE ANN DEWALL is noted as October 3, 2017 where the registry provides it.

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