Ketamine Health & Restoration, LLC.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

KETAMINE HEALTH & RESTORATION, LLC.

Practice address

585 Main St Ste 145
Laurel, MD 20707-4354

Phone

(301) 298-8267

Fax

(301) 517-9386

NPI assigned

Sep 13, 2023

Last updated

May 17, 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

Dr. Tiffany Owens, MDNPI 1104020817

Title

Owner

Phone

(301) 298-8267

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Tiffany S Owens, M.D.

  • Anesthesiology Physician
  • Charlotte, NC
  • NPI 1104020817
  Authorized official Same address or phone
• Abelina Maldonado, FNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Laurel, MD
  • NPI 1396212791

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1780461582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 MAIN ST STE 145",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074354",
            "telephone_number": "301-298-8267",
            "fax_number": "301-517-9386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 MAIN ST STE 145",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074354",
            "telephone_number": "301-298-8267",
            "fax_number": "301-517-9386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETAMINE HEALTH & RESTORATION, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-13",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-298-8267",
        "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": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leighton Kennedy, PMHNP, BC
• Lillian Kathleen Kennedy
• Charlotte Rose Kerr, L.AC., R.N.
• Ronald Michael Kerrick, D.D.S.
• Shylaja Unnikrishna Keshav, MD
• Joysline Ketum
• Larissa Ketum, HHA
• Anna Keyaka
• Keys Development Ta
• Keystone Healthcare Services LLC

• Anesthesiology Physician in Laurel, MD
• Providers in Laurel, MD by specialty
• Anesthesiology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.