Charles Pipkin, LCSW # SW 17370

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17370 Issued in FL

Practice address

112 W Cervantes St
Pensacola, FL 32501-3128

Phone

(850) 972-8455

NPI assigned

May 17, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Adult & Child Mental Health Care

  • Community/Behavioral Health Agency
  • Pensacola, FL
  • NPI 1871898106

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1750947446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 W CERVANTES ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013128",
            "telephone_number": "850-972-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 W CERVANTES ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013128",
            "telephone_number": "850-972-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIPKIN",
        "first_name": "CHARLES",
        "credential": "LCSW # SW 17370",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-17",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "17370",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "12626",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracey Elizabeth Pinkston, MD
• Pinnacle Physicians LLC
• Michele Catherine Pino Sr., MS, RD, LD
• James Robert Piorkowski, MD
• Giovanni Piovesana, M.D.
• Scott Pippin, ATC
• Michael J Pistey, CRNA
• Meredith Pitard
• April Pittman
• Frances H. Pittman, RPH

• Clinical Social Worker in Pensacola, FL
• Providers in Pensacola, 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 Aug 21, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.