Ketamine Wellness Centers Jacksonville
NPI 1063016988ActiveOrganization· Anesthesiology, Pain Medicine· Jacksonville, FL
Anesthesiology, Pain Medicine in Jacksonville, Florida, registered in NPPES in November 2020, part of Ketamine Wellness Centers Arizona LLC. The authorized official on file is Anita Jerger, Executive Assistant.
Overview
| NPI | 1063016988 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Ketamine Wellness Centers Arizona LLC |
| NPI issued | Nov 23, 2020 |
| Last updated in NPPES | Nov 23, 2020 |
| Certified by provider | Nov 23, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Anesthesiology, Pain Medicine Primary | 207LP2900X | — | — |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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