KETAMINE TREATMENT SERVICES (NPI# 1669027595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669027595 |
| Entity Type | Organization |
| Organization Name | KETAMINE TREATMENT SERVICES |
| Practice Address |
3015 Dunes West Blvd Ste 510 Mount Pleasant SC 29466-8252 |
| Mailing Address |
1851 Delacourt Ave Mount Pleasant SC 29466-9252 |
| Practice Telephone | 8437148020 |
| Mailing Telephone | 8437148020 |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2019-08-07 |
| Authorized Official Name | SCOTT WILLIAM SMITH (OWNER/PRESIDENT) |
| Authorized Official Telephone | 8437148020 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Dunes West Medical Clinic | Doing Business As Name - Organization |
| Street Address |
3015 DUNES WEST BLVD STE 510 |
| City | MOUNT PLEASANT |
| State | SC |
| Zip Code | 29466-8252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689276 | Sweetgrass Pharmacy Carolina Park, LLC | Pharmacy | 3485 Park Avenue Blvd, Mount Pleasant, SC 29466 | 2020-11-02 |
| 1942836754 | Southern Grace Pain & Regenerative Medicine | Clinic/Center | 3520 Park Avenue Blvd., Suite 105, Mount Pleasant, SC 29466 | 2020-03-13 |
| 1174175038 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 225 Faison Rd, Mount Pleasant, SC 29466 | 2019-07-11 |
| 1780246553 | Stacy Nicole Sherbutt | Dental Hygienist | Naval Weapons Statiom, 316 Red Bank Rd, Goose Creek, SC 29466 | 2019-07-02 |
| 1144780909 | Chantal Pilar Debreceny | Nurse Practitioner | 1167 Basketweave Drive, #204, Mount Pleasant, SC 29466 | 2019-03-20 |
| 1609364835 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 3525 Park Ave Blvd., Mount Pleasant, SC 29466 | 2018-04-24 |
| 1528561453 | Sea Island Medical Care | Clinic/Center | 2114 Highway 41, Suite 105, Mount Pleasant, SC 29466 | 2018-03-16 |
| 1992217707 | Kristina Estelle Johnson | Family Medicine | 2662, Lohr Dr, Mount Pleasant, SC 29466 | 2017-11-02 |
| 1801324181 | Collin T Weyer | Physical Therapist | 3301 Stockdale Street, Suite B, Mt. Pleasant, SC 29466 | 2017-05-31 |
| 1023467479 | Mariesa Eikevik | Physical Therapist | 3559 Franklin Tower Dr, Mount Pleasant, SC 29466 | 2016-06-07 |
| Find all providers in zip 29466 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487213724 | Greater Greenwood United Ministry | Family Medicine | 1404 Edgefield Street, Greenwood, SC 29646 | 2019-06-11 |
| 1164995346 | Rachelle Shepard | Family Medicine | 144 Whitehurst Way, Columbia, SC 29229-8500 | 2019-01-10 |
| 1255848834 | Mobile Medical LLC | Family Medicine | 1002 Shipmaster Ave, Myrtle Beach, SC 29579-5142 | 2018-01-04 |
| 1891035416 | Donald F Wade | Family Medicine | 1728 Vassar Dr, Charleston, SC 29407-4236 | 2013-02-19 |
| 1770880486 | James Stuart Mcdaniel | Family Medicine | 1140 Pilot Boy, Wadmalaw Island, SC 29487-6993 | 2011-02-15 |
| 1356672927 | Bledsoe Family Medicine LLC | Family Medicine | 669 Barr Rd Ste C, Lexington, SC 29072-2369 | 2010-01-21 |
| 1295974509 | John Browning Mcree | Family Medicine | S Carolina Dept of Corrections, Redemption Way, Mc Cormick, SC 29899-0001 | 2009-02-10 |
| 1174795900 | Gordon R. Weigle, Md Pa | Family Medicine | 1717 Village Park Dr, Orangeburg, SC 29118-2475 | 2008-04-01 |
| 1437370061 | Samuel Johnston Orr | Family Medicine | 140 Forest Hills Dr, Gaffney, SC 29340-2837 | 2007-05-01 |
| 1780613455 | Paul Manuel Espinoza | Family Medicine | 2660 Kinard St, Newberry, SC 29108-2912 | 2006-07-03 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT PLEASANT |
| Zip Code | 29466 |
Please comment or provide details below to improve the information on KETAMINE TREATMENT SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.