NPIMap

Organization Active NPI

Virginia Beach Ketamine & Wellness

  • Clinic/Center
  • Virginia Beach, VA
National Provider Identifier
1851065676
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
VIRGINIA BEACH KETAMINE & WELLNESS
Practice address
1856 Colonial Medical CT Ste D
Virginia Beach, VA 23454-3075
Phone
(757) 751-0800
NPI assigned
Aug 4, 2021
Last updated
Aug 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Authorized official

Name
Tricia Lee, CRNA, NPNPI 1477562502
Title
Co-Owner
Phone
(757) 412-7030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1856 Colonial Medical CT Ste D
Virginia Beach, VA 23454-3075

Mailing address

1856 Colonial Medical CT Ste D
Virginia Beach, VA 23454-3075
Phone (757) 751-0800

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Vbketamine@gmail.com

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628035200000",
    "number": "1851065676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1856 COLONIAL MEDICAL CT STE D",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543075",
            "telephone_number": "757-751-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1856 COLONIAL MEDICAL CT STE D",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543075",
            "telephone_number": "757-751-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA BEACH KETAMINE & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "757-412-7030",
        "authorized_official_credential": "CRNA, NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Vbketamine@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "1856 Colonial Medical Ct Ste D",
            "city": "Virginia Beach",
            "state": "VA",
            "country_code": "US",
            "postal_code": "234543075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.