Ketamine Infusion Centers, Inc

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

KETAMINE INFUSION CENTERS, INC

Doing business as

Ketamine Infusion Centers

Practice address

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

Phone

(480) 331-4222

Fax

(480) 404-9649

NPI assigned

Oct 3, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Sonny Diaz

Title

Director

Phone

(602) 344-9850

Specialties & licenses 2

Addresses

Other names 1

• Ketamine Infusion Centers Doing business as

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627603200000",
    "number": "1740790823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 N 3RD ST STE 201",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122034",
            "telephone_number": "602-344-9850",
            "fax_number": "602-490-8894"
        },
        {
            "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": "480-331-4222",
            "fax_number": "480-404-9649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETAMINE INFUSION CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "SONNY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "602-344-9850",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ketamine Infusion Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roger Kessler, L.C.S.W.
• Jeri Kessman, PA
• Regan Kesting, M.S. SLP
• Sanjay Kestner, MC LPC
• Christina Mae Keszler, D.C.
• Ketamine Wellness Centers Phoenix LLC
• Kethcart Sleep LLC (Central Phoenix Center for TMJ, Pain & Sleep Disorders)
• Kethcart Smiles PLLC
• Kristoffer J Keul, LAC (LICENSED ASSOCI
• Katherine Keuth, LAMFT

• Infusion Therapy Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Infusion Therapy Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.