Clinic Ketamine PC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

CLINIC KETAMINE PC

Practice address

1121 River Wood
Seguin, TX 78155-0083

Phone

(800) 664-1539

Fax

(307) 448-4666

NPI assigned

Feb 20, 2020

Organization subpart

No

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

Authorized official

Name

Mr. John Christopher Kipple, APRN, MS, CRNA

Title

President

Phone

(800) 664-1539

Specialties & licenses 1

Addresses

Other names 1

• Comprehensive Pain Management Services Doing business as

Locations

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1669005336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1900",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781568900",
            "telephone_number": "800-664-1539",
            "fax_number": "307-448-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 RIVER WOOD",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781550083",
            "telephone_number": "800-664-1539",
            "fax_number": "307-448-4666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2210 Austin Ave",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767011625",
            "country_code": "US",
            "telephone_number": "254-235-0605",
            "fax_number": "254-752-8378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLINIC KETAMINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-20",
        "last_updated": "2025-09-02",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "KIPPLE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-664-1539",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN, MS, CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive Pain Management Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brian Christianson
• Jennifer Cirilo, FNP-C
• City of Seguin
• Clark Colville and Kelly Heetland Specialty Partners of Texas PLLC
• Danie Marie Clifton, LVN
• Sheri Kay Colbath
• Triniqua Collins
• Clark D Colville, D.D.S., M.S.
• Jim T Colvin Jr., MD
• Community Council of South Central Texas, Inc.

• All providers in Seguin, TX
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.