Active NPI
Ken J Gabel
- Clinical Psychologist
- Fort Collins, CO
National Provider Identifier
1780792358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY.0003588
- Practice address
- 219 W Magnolia St
Fort Collins
Fort Collins, CO 80521-2926 - Phone
- (970) 599-1510
- Fax
- (970) 541-7966
- NPI assigned
- Aug 25, 2006
- Last updated
- Oct 28, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY.0003588 | CO | Primary |
Addresses
Primary practice location
219 W Magnolia St
Fort Collins
Fort Collins, CO 80521-2926
Mailing address
PO Box 1363
Loveland
Loveland, CO 80539-1363
Phone (970) 599-1510
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150220001171 | CO | Practitioner - Clinical Psychologist | 4789670175 | Practice locations: Boulder, CO; Fort Collins, CO |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3588 | CO | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414454400000",
"number": "1780792358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1363",
"address_2": "LOVELAND",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805391363",
"telephone_number": "970-599-1510",
"fax_number": "970-541-7966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "219 W MAGNOLIA ST",
"address_2": "FORT COLLINS",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805212926",
"telephone_number": "970-599-1510",
"fax_number": "970-541-7966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GABEL",
"first_name": "KEN",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2014-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "PSY.0003588",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.