Active NPI
David Blake Shipp, LMSW
- Social Worker
- Vestal, NY
National Provider Identifier
1487367074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 115935
- Practice address
- 4417 Vestal Pkwy E
Vestal, NY 13850-3556 - Phone
- (607) 797-1251
- Fax
- (607) 729-4393
- NPI assigned
- Dec 29, 2022
- Last updated
- Mar 16, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 115935 | NY | Primary |
| Clinical Social Worker | 1041C0700X | 102358 | NY |
Addresses
Primary practice location
4417 Vestal Pkwy E
Vestal, NY 13850-3556
Mailing address
33 Lewis Rd FL 2
Binghamton, NY 13905-1055
Phone (607) 770-0025
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
33 Lewis Rd
Binghamton, NY 13905-1013
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115935 | NY | MD | Social Worker |
| 102358 | NY | MD | Clinical Social Worker |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Johnson City, NY
- NPI 1962463851
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773619200000",
"number": "1487367074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 LEWIS RD FL 2",
"city": "BINGHAMTON",
"state": "NY",
"postal_code": "139051055",
"telephone_number": "607-770-0025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4417 VESTAL PKWY E",
"city": "VESTAL",
"state": "NY",
"postal_code": "138503556",
"telephone_number": "607-797-1251",
"fax_number": "607-729-4393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIPP",
"first_name": "DAVID",
"middle_name": "BLAKE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-29",
"last_updated": "2026-03-16",
"certification_date": "2026-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "115935",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "102358",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vestal, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.