Ketamine Wellness Centers Phoenix LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

KETAMINE WELLNESS CENTERS PHOENIX LLC

Practice address

3724 N 3Rd St Ste 201
Phoenix, AZ 85012-2034

Phone

(480) 788-8539

NPI assigned

Jan 6, 2022

Last updated

Jan 10, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

KETAMINE WELLNESS CENTERS ARIZONA LLCAs reported in NPPES

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

Authorized official

Name

Anita Jerger

Title

Executive Assistant

Phone

(480) 993-2227

Specialties & licenses 1

Addresses

Other names 1

• Ketamine Infusion Centers Former legal business name

Part of

Ketamine Wellness Centers Arizona LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Ketamine Wellness Centers Arizona LLC

  dba Ketamine Wellness Centers

  • Anesthesiology Physician
  • Mesa, AZ
  • NPI 1477935369
  NPPES parent name

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1205597788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 W BASELINE RD STE A-182",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852025820",
            "telephone_number": "480-993-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3724 N 3RD ST STE 201",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122034",
            "telephone_number": "480-788-8539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETAMINE WELLNESS CENTERS PHOENIX LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KETAMINE WELLNESS CENTERS ARIZONA LLC",
        "enumeration_date": "2022-01-06",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "JERGER",
        "authorized_official_first_name": "ANITA",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "480-993-2227"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ketamine Infusion Centers",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jeri Kessman, PA
• Regan Kesting, M.S. SLP
• Sanjay Kestner, MC LPC
• Christina Mae Keszler, D.C.
• Ketamine Infusion Centers, Inc (Ketamine Infusion Centers)
• Kethcart Sleep LLC (Central Phoenix Center for TMJ, Pain & Sleep Disorders)
• Kethcart Smiles PLLC
• Kristoffer J Keul, LAC (LICENSED ASSOCI
• Katherine Keuth, LAMFT
• Angie Buono Kevane, RDH, BSDH

• Anesthesiology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Anesthesiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.