Ketaminamd LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

KETAMINAMD LLC

Practice address

930 S 4TH St Ste 209
Las Vegas, NV 89101-6845

Phone

(929) 494-1182

Fax

(929) 494-1182

NPI assigned

Nov 27, 2023

Organization subpart

No

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

Authorized official

Name

Matthew Sessa

Title

Authorizing Representative

Phone

(929) 494-1182

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1063288686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 S 4TH ST STE 209",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891016845",
            "telephone_number": "929-494-1182",
            "fax_number": "929-494-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 S 4TH ST STE 209",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891016845",
            "telephone_number": "929-494-1182",
            "fax_number": "929-494-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETAMINAMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-27",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "SESSA",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "AUTHORIZING REPRESENTATIVE",
        "authorized_official_telephone_number": "929-494-1182"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Kester
• Shirley Jean Kester
• Tenaya Kesterson
• Christine Kestner
• Kunnara Ket, PTA
• Ketamine Wellness Centers Las Vegas
• Carl Anderson Ketcham, DO
• Courtney Ketcham
• Andrea Ketchum
• David C Ketchum, D.C.

• Case Management Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Case Management Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.