Ketamine Infusion Specialists

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

KETAMINE INFUSION SPECIALISTS

Practice address

525 North Ave
Grand Junction, CO 81501-7512

Phone

(970) 778-3753

Fax

(970) 778-3754

NPI assigned

Oct 9, 2024

Last updated

Oct 9, 2024By 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

Angela Pennell, MDNPI 1124242177

Title

President

Phone

(970) 778-3753

Specialties & licenses 1

Addresses

Other names 1

• Ketamine Infusion and Wellness Specialists Other name

Practitioners 1

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.

• Angela M Pennell, M.D.

  • Anesthesiology Physician
  • Grand Junction, CO
  • NPI 1124242177
  NPD Authorized official

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1225857956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 NORTH AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815017512",
            "telephone_number": "970-778-3753",
            "fax_number": "970-778-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 NORTH AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815017512",
            "telephone_number": "970-778-3753",
            "fax_number": "970-778-3754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETAMINE INFUSION SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "PENNELL",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-778-3753",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ketamine Infusion and Wellness Specialists",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mark Allen Kennedy
• Kenneth C. Lewis MD,LLC
• Kenneth C. Lewis MD,LLC
• Kelsey Lee Kerton, D.O.
• Bradley Robert Kessler
• Ketamine West LLC
• Julie A Ketchem, BA
• Sheryl Ketchum
• Kevin H. Howell DO
• Kevin K Howell

• Anesthesiology Physician in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Anesthesiology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.