Southern Ketamine and Wellness LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

SOUTHERN KETAMINE AND WELLNESS LLC

Practice address

1932 Laurel Rd Ste 1B
Vestavia Hills, AL 35216-1939

Phone

(205) 202-9163

NPI assigned

Jan 11, 2023

Organization subpart

No

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

Authorized official

Name

Dr. John Harrison Irons, MD

Title

Co-Owner

Phone

(205) 202-9163

Specialties & licenses 4

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy Lucas Hicks, CRNP

  • Family Nurse Practitioner
  • Vestavia Hills, AL
  • NPI 1497592208
  NPD (past)

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

{
    "created_epoch": "1673395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1700590007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1932 LAUREL RD STE 1B",
            "city": "VESTAVIA HILLS",
            "state": "AL",
            "postal_code": "352161939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1932 LAUREL RD STE 1B",
            "city": "VESTAVIA HILLS",
            "state": "AL",
            "postal_code": "352161939",
            "telephone_number": "205-202-9163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN KETAMINE AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "IRONS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "HARRISON",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "205-202-9163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee Cheyenne Smith
• Codie Lani Smith, MS, LPC
• Jerri Hendrix Smith, MCD, CCC-SLP
• Julie Smith, PHARMD
• Katy Sarah Smith, OTR/L
• Southern Ketamine and Wellness, LLC
• Spark Counseling & Consulting LLC
• Angela Spears, CRNP
• Lauren Sponaugle
• Melanie Hardee Spooner, DMD

• Pain Medicine (Anesthesiology) Physician in Vestavia Hills, AL
• Providers in Vestavia Hills, AL by specialty
• Pain Medicine (Anesthesiology) Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.