KIM SHIPPEY LCSW
NPI 1497817670
Social Worker - Clinical in Santa Rosa, CA
About Kim Shippey Lcsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KIM SHIPPEY LCSW (NPI 1497817670) is an individual clinical provider in Santa Rosa, California, licensed in California (17312) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1991).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kim Shippey Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
4Medicare enrollment records show Kim Shippey reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Santa Rosa, CA 95403
- Reassigned Medicare billing, California enrollment
- 215 clinicians in this Medicare group
Vallejo, CA 94589
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
Santa Clara, CA 95054
- Reassigned Medicare billing, California enrollment
- 1,607 clinicians in this Medicare group
Santa Rosa, CA 95401
- Reassigned Medicare billing, California enrollment
- 33 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 95403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SANTA ROSA, CA 95403
SANTA ROSA, CA 95403
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kim Shippey's NPI number?
The NPI number for Kim Shippey is 1497817670. It was assigned to this individual provider in the NPPES registry on December 14, 2006.
Where is Kim Shippey located?
Kim Shippey practices at 401 Bicentennial Way Adult Psychiatry, Santa Rosa, CA 95403. The listed phone number is (707) 571-4015.
What is Kim Shippey's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Kim Shippey enrolled in Medicare?
Yes. Kim Shippey is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Kim Shippey's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kim Shippey reassigns Medicare benefits to 4 organizations: Santa Rosa Community Health Centers (Santa Rosa, CA), Permanente Medical Group Inc (Vallejo, CA), Sud Specialty Group - Ca (Santa Clara, CA) and Psych Strategies Inc A Psychological Corp (Santa Rosa, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kim Shippey's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kim Shippey was last updated on January 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kim Shippey, LCSW · NPI 1497817670
Clinical provider in Santa Rosa, California. Individual provider, active in the CMS NPPES registry since December 14, 2006.
## Identity
- **NPI:** 1497817670 (Entity type: Individual)
- **Enumerated:** December 14, 2006
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** 17312 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 401 BICENTENNIAL WAY, ADULT PSYCHIATRY, Santa Rosa, CA 95403-2149
- **Phone:** (707) 571-4015
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Santa Rosa Community Health Centers (NPI 1578631172, Santa Rosa, CA); Permanente Medical Group Inc (NPI 1336222397, Vallejo, CA); Sud Specialty Group - Ca (NPI 1972138238, Santa Clara, CA); Psych Strategies Inc A Psychological Corp (NPI 1699775411, Santa Rosa, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1991
## Record status
- **NPPES last updated:** January 3, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1497817670) · Data from the CMS NPPES public registry.