Iowa Ketamine Infusion, LLC

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

IOWA KETAMINE INFUSION, LLC

Practice address

1701 48TH St Ste 260
West Des Moines, IA 50266-6726

Phone

(515) 401-4774

Fax

(515) 254-3092

NPI assigned

Jun 27, 2024

Last updated

Oct 5, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mindy Gingery, PMHNP, ARNP, CRNANPI 1124026042

Title

Ceo

Phone

(515) 988-1564

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mindy Kay Gingery, PMHNP-BC, CRNA

  • Psychiatric/Mental Health Nurse Practitioner
  • Ankeny, IA
  • NPI 1124026042
  Authorized official Same address or phone
• Shawn Tulp, CRNA

  • Certified Registered Nurse Anesthetist
  • Webster City, IA
  • NPI 1255767778
  NPD

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759622400000",
    "number": "1033954508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 48TH ST STE 260",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502666726",
            "telephone_number": "515-401-4774",
            "fax_number": "515-254-3092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 48TH ST STE 260",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502666726",
            "telephone_number": "515-401-4774",
            "fax_number": "515-254-3092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1960 SW Magazine Rd",
            "address_purpose": "LOCATION",
            "city": "Ankeny",
            "state": "IA",
            "postal_code": "500232978",
            "country_code": "US",
            "telephone_number": "515-401-4774",
            "fax_number": "515-254-3092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IOWA KETAMINE INFUSION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-27",
        "last_updated": "2025-10-05",
        "certification_date": "2025-10-05",
        "status": "A",
        "authorized_official_last_name": "GINGERY",
        "authorized_official_first_name": "MINDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-988-1564",
        "authorized_official_credential": "PMHNP, ARNP, CRNA"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Infusion Therapy Clinic/Center in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Infusion Therapy Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.