865 Wellness Ketamine LLC
NPI 1912696808ActiveOrganization· Nurse Anesthetist, Certified Registered· Knoxville, TN
Nurse Anesthetist, Certified Registered in Knoxville, Tennessee, registered in NPPES in May 2023. The authorized official on file is Jennifer Watson, CRNA, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1912696808 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 5, 2023 |
| Last updated in NPPES | Jul 23, 2025 |
| Certified by provider | Jul 23, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Anesthetist, Certified Registered Primary | 367500000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TN) |
|---|
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