Shannon Gambill, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1911 Issued in KY

Practice address

4010 Dupont Cir Ste 582
Louisville, KY 40207-4888

Phone

(502) 899-5411

NPI assigned

Nov 17, 2013

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 KY

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, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• PPL Therapeutic Services PLLC

  • Professional Counselor
  • Crestwood, KY
  • NPI 1104323252

  Clinical

  Medicare reassignment NPD
• Therapeutic Intervention Services

  • Community/Behavioral Health Agency
  • Louisville, KY
  • NPI 1932467867

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1384646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384646400000",
    "number": "1770913436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2536 RIDGEWOOD AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171949",
            "telephone_number": "502-649-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR STE 582",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074888",
            "telephone_number": "502-899-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBILL",
        "first_name": "SHANNON",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-17",
        "last_updated": "2013-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "1911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elkin Jair Galvis Leon, MD
• Juan Manuel Galvis, M.D.
• Marcelo Daniel Gamarra, MD
• Christopher Gambert, DPT
• Kevin Heath Gambill
• Collin Gamble
• Lindsay Gamble, MD
• Jonathan David Gambrell, M.D.
• Pamela Gambrell, NP
• Sara E Gambrell, CSW

• Clinical Social Worker in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2013; 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.