Catherine Wallace, NP
Individual provider Active NPI Obstetrics & Gynecology Nurse Practitioner · Clive, IA
NPI 1033200431 · NPPES record last updated Jul 28, 2025
Key facts
- NPI
- 1033200431
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner 363LX0001X
- License
- A106126 (IA)
- Practice address
- 12339 Stratford Dr
Clive, IA 50325-8148 - Phone
- (515) 263-9107
- Fax
- (515) 265-9888
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Iowa Physicians Clinic Medical Foundation
Practice addresses (Care Compare)
12339 Stratford Dr
Clive, IA 50325-8148
Phone (515) 263-9107
30 E Hickman Rd
Family Med Waukee
Waukee, IA 50263-5011
Phone (515) 987-3447
40 E Hickman Rd
Pediatrics Waukee
Waukee, IA 50263-5011
Phone (515) 987-6610
4480 Utica Ridge Rd
Bettendorf, IA 52722-1644
4480 Utica Ridge Rd
Suite 160
Bettendorf, IA 52722-1637
Phone (563) 742-5950
50 E Hickman Rd
PT Waukee
Waukee, IA 50263-5011
Phone (515) 216-2999
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140421001416 | IA | Practitioner - Nurse Practitioner | 8820220106 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A106126 | IA | MD | Obstetrics & Gynecology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iowa Physicians Clinic Medical Foundation | Current |
Accepting new patients | |
| St Luke'S Methodist Hospital | Current | Accepting new patients |
Locations
4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950
4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150
12339 Stratford Dr
Clive, IA 50325
Phone (515) 263-9107
1440 Pleasant St
Ste 1
Des Moines, IA 50314
Phone (515) 241-8383
1250 E 9th St
Des Moines, IA 50316
Phone (515) 241-4300
Interoperability endpoints
- cwallace13100@direct.unitypoint.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | A106126 | IA | |
| Perinatal Nurse Practitioner | 363LP1700X | A106126 | IA | |
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | A106126 | IA | Yes |
Addresses
Primary practice location
12339 Stratford Dr
Clive, IA 50325-8148
Mailing address
12339 Stratford Dr
Clive, IA 50325-8148
Phone (515) 263-9107
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IA0104 | Other | IA | JOHN DEERE |
| 1033200431 | Medicaid | IA |
Other providers in Clive, IA
- Rachel Wakefield
- Walgreen Co
- Walgreen Co
- Paradise Walker-Cain
- Marvin Dean Walker
- Timothy William Walsh
- Rachel Wanninger
- Lindsay Ward
- Catherine Wargo
- Molly Warner
All providers in Clive, IA · Obstetrics & Gynecology Nurse Practitioner in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.