JACQUELINE ANN WEYDERT (LISW) – Clinical Social Worker, NPI 1871752436

JACQUELINE ANN WEYDERT (LISW) is a healthcare provider. based in Grinnell, Iowa. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LISW. They hold a License No. 06609 (IA). The NPI Number for JACQUELINE ANN WEYDERT (LISW) is 1871752436

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
JACQUELINE ANN WEYDERT (LISW)
NPI
1871752436
Phone
(641) 236-6137
Address
200 4TH AVE W
Enumeration Date
8 June 2008
Last Update Date
25 November 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6363009333
Graduation Year
2005 (21 years ago)
PAC ID
7012072192
Group Practice PAC ID
5496649022
Professional Enrollment ID
I20170613001570
Address ID
MO633688406OX4142XBLVD401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

828 CLINICAL SOCIAL WORKER in IA

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Provider Addresses for JACQUELINE ANN WEYDERT (LISW)

  • 200, 4th Avenue West, Grinnell, Poweshiek County, Iowa, 50112, United States

    GRINNELL, IA 501121833

    Phone: (641) 236-6137

    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: 2017-06-13

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170613001570IClinical Social WorkerMOTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour47520$0
View full utilization report →

Insurance plans in this area (ZIP 50112)

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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: 5496649022View full group profile
NameSpecialtyState
Clinical PsychologistMO
Clinical PsychologistMO
-MO
Clinical Social WorkerMO
Clinical Social WorkerMO

Reviews

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Frequently asked questions

Is JACQUELINE ANN WEYDERT (LISW) listed with a National Provider Identifier?
Yes — JACQUELINE ANN WEYDERT (LISW) has NPI 1871752436 on file in the registry.
Is JACQUELINE ANN WEYDERT (LISW) still an active registrant?
JACQUELINE ANN WEYDERT (LISW) carries an active NPI according to the public dataset.
What kind of doctor is JACQUELINE ANN WEYDERT (LISW)?
JACQUELINE ANN WEYDERT (LISW) is associated with Clinical Social Worker in the directory — Clinical services aligned with this taxonomy classification.
Is JACQUELINE ANN WEYDERT (LISW) located near Grinnell?
JACQUELINE ANN WEYDERT (LISW) currently maps to Grinnell, Iowa in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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