Individual provider Active NPI

Kristen H Grable, M.D.

  • Psychiatry Physician
  • Dallas, TX
National Provider Identifier
1720001118
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
J8557 Issued in TX
Practice address
4645 Samuell Blvd
Dallas, TX 75228-6826
Phone
(214) 275-7393
Fax
(214) 381-6617
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X J8557 TX Primary

Addresses

Primary practice location

4645 Samuell Blvd
Dallas, TX 75228-6826

Mailing address

PO Box 1416
Rockwall, TX 75087-1416
Phone (972) 768-3900

Other identifiers 1

IdentifierTypeStateIssuer
1473308-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110119001018 TX Practitioner - Psychiatry 1254510514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Medical School at Houston, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lakes Regional Mental Health Mental Retardation CenterGroup PAC ID 9739175225, 18 clinicians

Practice addresses (Care Compare)

1300 W 16TH St
Mt Pleasant, TX 75455-2046
Phone 97252441591183

400 Airport Rd
Terrell, TX 75160-4302
Phone 97252441591183

4200 Stuart St
Greenville, TX 75401-5759
Phone 97252441591183

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J8557TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakes Regional Mental Health Mental Retardation Center CurrentSince Jul 9, 2012 Accepting new patients
Dallas County Mental Health & Mental Retardation Center Psychiatry Past Accepting new patients

Locations

1300 W 16th St
Mt Pleasant, TX 75455
Phone (972) 524-4159

395 N Main St
Paris, TX 75460
Phone (903) 737-2475

655 Airport Rd
Sulphur Springs, TX 75482
Phone (903) 438-3270

400 Airport Rd
Terrell, TX 75160
Phone (972) 524-4159

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720001118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1416",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750871416",
            "telephone_number": "972-768-3900",
            "fax_number": "214-381-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 SAMUELL BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752286826",
            "telephone_number": "214-275-7393",
            "fax_number": "214-381-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABLE",
        "first_name": "KRISTEN",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "J8557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1473308-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.