Individual provider Active NPI

Deborah Lynne Garrelts-Daoud, M.D.

  • Psychiatry Physician
  • Waterloo, IA
National Provider Identifier
1215025309
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
34569 Issued in IA
Practice address
3251 W 9TH St
Waterloo, IA 50702-5310
Phone
(319) 234-2893
Fax
(319) 234-0354
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036-100370 IL
Psychiatry Physician 2084P0800X 34569 IA Primary

Addresses

Primary practice location

3251 W 9TH St
Waterloo, IA 50702-5310

Mailing address

3908 Beaver Ridge TRL
Cedar Falls, IA 50613-9400
Phone (319) 277-3004

Other practice location 1

1200 W State St
Rockford, IL 61102-2112
Phone (815) 490-1600

Other identifiers 1

IdentifierTypeStateIssuer
0074435MedicaidIA

Other names 1

  • Deborah Lynne Garrelts Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34569IAMDPsychiatry Physician
036-100370ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McDonough County Hospital District CurrentSince Apr 4, 2022 Accepting new patients
Allen Memorial Hospital Corporation Psychiatry CurrentSince Sep 24, 2018 Accepting new patients
Allen Memorial Hospital Corporation CurrentSince Sep 24, 2018 Accepting new patients
McDonough County Hospital District CurrentSince Apr 4, 2022 Accepting new patients

Locations

1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886

503 E Grant St
Macomb, IL 61455
Phone (309) 833-5917

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1215025309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3908 BEAVER RIDGE TRL",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506139400",
            "telephone_number": "319-277-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025310",
            "telephone_number": "319-234-2893",
            "fax_number": "319-234-0354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 W State St",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611022112",
            "country_code": "US",
            "telephone_number": "815-490-1600",
            "fax_number": "815-490-1881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARRELTS-DAOUD",
        "first_name": "DEBORAH",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-100370",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "34569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0074435",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "GARRELTS",
            "middle_name": "LYNNE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.