Kolby Mertz Gambill, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60163613 Issued in WA

Practice address

1136 Water St Ste 102
Port Townsend, WA 98368-6728

Phone

(360) 207-4745

NPI assigned

Jul 31, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jefferson County Public Hospital District No 2Group PAC ID 4789593708, 151 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Jefferson County Public Hospital District No 2

  • Critical Access Hospital
  • Port Townsend, WA
  • NPI 1356492953
  Medicare reassignment Care Compare group
• Jefferson County Public Hospital District No 2

  • Rural Health Clinic/Center
  • Quilcene, WA
  • NPI 1780897074
  NPD (past)
• Jefferson County Public Hospital District No 2

  • Rural Health Clinic/Center
  • Port Ludlow, WA
  • NPI 1801188073
  NPD (past)
• Jefferson County Public Hospital District No 2

  • Rural Health Clinic/Center
  • Port Townsend, WA
  • NPI 1902850753
  NPD (past)

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1669858601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 WATER ST STE 102",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983686728",
            "telephone_number": "360-207-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 WATER ST STE 102",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983686728",
            "telephone_number": "360-207-4745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Sheridan Street, STE 101",
            "address_purpose": "LOCATION",
            "city": "Port Townsend",
            "state": "WA",
            "postal_code": "98368",
            "country_code": "US",
            "telephone_number": "360-385-3500",
            "fax_number": "360-385-5496",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "294843 US Highway 101",
            "address_purpose": "LOCATION",
            "city": "Quilcene",
            "state": "WA",
            "postal_code": "983769800",
            "country_code": "US",
            "telephone_number": "603-853-9913",
            "fax_number": "360-765-3811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "89 Breaker Ln",
            "address_purpose": "LOCATION",
            "city": "Port Ludlow",
            "state": "WA",
            "postal_code": "983659766",
            "country_code": "US",
            "telephone_number": "360-437-4158",
            "fax_number": "360-437-4158",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "915 Sheridan St",
            "address_purpose": "LOCATION",
            "city": "Port Townsend",
            "state": "WA",
            "postal_code": "983682931",
            "country_code": "US",
            "telephone_number": "360-385-4848",
            "fax_number": "360-379-4383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "934 Sheridan Street",
            "address_purpose": "LOCATION",
            "city": "Port Townsend",
            "state": "WA",
            "postal_code": "98368",
            "country_code": "US",
            "telephone_number": "360-385-5388",
            "fax_number": "360-385-0433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMBILL",
        "first_name": "KOLBY",
        "middle_name": "MERTZ",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60163613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fred Meyer Stores Inc
• Talya Freudmann, RN, MSN, FNP-BC
• Katherine Fuentes
• Alison M Fulton, LMHC
• Laura Gallo, MS CCC/SLP
• Yefim Gamgoneishvili, L.AC
• Jessica Garcia, LMHC
• Judith McCarty Gayne, M.D.
• Deborah Elizabeth Gellert, LMHC
• Kristina A Germeau

• Clinical Social Worker in Port Townsend, WA
• Providers in Port Townsend, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.

Verify at the official NPI Registry.