Individual provider Active NPI

Dawn Shaner Gable, PHD HSPP

  • Clinical Psychologist
  • Evansville, IN
National Provider Identifier
1043363963
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20041439A Issued in IN
Practice address
819 W Franklin St
Evansville, IN 47710-1137
Phone
(812) 491-1805
Fax
(812) 491-1929
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20041439A IN Primary

Addresses

Primary practice location

819 W Franklin St
Evansville, IN 47710-1137

Mailing address

9000 Marfield CT
Evansville, IN 47712-5417
Phone (812) 685-0065

Other names 1

  • Ms. Shaner Dawn Gable Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20050421001424 IN Practitioner - Clinical Psychologist 7315985280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

815 John St
Evansville, IN 47713-2746
Phone (812) 483-2217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Acacia Center for Human Growth & Development, Inc. Clinical CurrentSince Apr 1, 2005 Accepting new patients

Locations

815 John St
Evansville, IN 47713
Phone (812) 454-8829

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1043363963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 MARFIELD CT",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477125417",
            "telephone_number": "812-685-0065",
            "fax_number": "812-491-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 W FRANKLIN ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101137",
            "telephone_number": "812-491-1805",
            "fax_number": "812-491-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABLE",
        "first_name": "DAWN",
        "middle_name": "SHANER",
        "name_prefix": "Ms.",
        "credential": "PHD HSPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041439A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANER",
            "last_name": "GABLE",
            "middle_name": "DAWN",
            "prefix": "MS.",
            "credential": "PHD HSPP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.