LISA WILLSON – Speech-Language Pathologist, NPI 1225459316

LISA WILLSON is a healthcare provider. based in Bettendorf, Iowa. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. They hold a License No. 002257 (IA). The NPI Number for LISA WILLSON is 1225459316

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
LISA WILLSON
NPI
1225459316
Phone
(563) 326-1400
Address
3740 UTICA RIDGE RD
Enumeration Date
17 December 2013
Last Update Date
17 December 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9892628500
Graduation Year
2012 (14 years ago)
PAC ID
9436381696
Group Practice PAC ID
8820244221
Professional Enrollment ID
I20181108000450
Address ID
MI487341255FR184XXSTXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

127 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in IA

Provider Addresses for LISA WILLSON

  • 3740 UTICA RIDGE RD

    SUITE 4

    BETTENDORF, IA 527221657

    Phone: (563) 326-1400

    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: 2018-11-08

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
I20181108000450IQualified Speech Language PathologistMITBD

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 52722)

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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: 8820244221View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Occupational Therapist In Private PracticeMI
Qualified Speech Language PathologistMI
-MI
Occupational Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI

Reviews

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Frequently asked questions

Does LISA WILLSON have a public NPI I can cite?
Public records show LISA WILLSON under NPI 1225459316.
Is LISA WILLSON's NPI status active today?
Active status means LISA WILLSON's NPI record is not deactivated in the public file.
How should patients interpret LISA WILLSON's specialty?
The extract shows Speech-Language Pathologist for LISA WILLSON. Clinical services aligned with this taxonomy classification.
Is LISA WILLSON tied to Bettendorf, Iowa?
If you are local to Bettendorf, Iowa, LISA WILLSON may be relevant to your search.
Why is information missing for LISA WILLSON?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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