David Shoots, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW6973 Issued in FL

Practice address

140 South Beach
Daytona Beach, FL 32114-4385

Phone

(386) 747-2331

NPI assigned

Feb 26, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lifestream Behavioral Center Inc

  • Primary Care Clinic/Center
  • Leesburg, FL
  • NPI 1659613776
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510704000000",
    "number": "1013043900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 S BEACH ST",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144472",
            "telephone_number": "386-747-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 SOUTH BEACH",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144385",
            "telephone_number": "386-747-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOTS",
        "first_name": "DAVID",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2017-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW6973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "764418300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nikita Shinn
• Michael Shippole
• Dmitriy Shishkin
• Jeevan Shivakumar, MD
• Kiran Shivaraj
• Shores Rehab Inc
• Hadassah Rose Shores
• Kushagra Shrinath, MD
• Apurwa Shukla
• Erin Leigh Shumans

• Clinical Social Worker in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.