The Minnesota Ketamine and Wellness Institute PA
NPI 1003408857ActiveOrganization· Anesthesiology· Maple Grove, MN
Anesthesiology in Maple Grove, Minnesota, registered in NPPES in February 2021. The authorized official on file is Christena Regena Hatcher, CRNA, Cfo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1003408857 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 3, 2021 |
| Last updated in NPPES | Aug 20, 2021 |
| Certified by provider | Aug 20, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Anesthesiology Primary | 207L00000X | — | — |
| Clinic/Center, Infusion Therapy | 261QI0500X | — | — |
| Clinic/Center, Adult Mental Health | 261QM0850X | — | — |
| Clinic/Center, Multi-Specialty | 261QM1300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MN) |
|---|
Other Anesthesiology providers in Maple Grove
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- 1730068032