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KETAMINE RVA
NPI 1063234615
Clinic/Center - Mental Health (Including Community Mental Health Center) in Henrico, VA

Active since October 25, 2024
8639 MAYLAND DR STE 102, HENRICO, VA 23294(804) 993-3039 Get Directions Write a Review

NPPES record last updated: October 25, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ketamine Rva NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KETAMINE RVA (NPI 1063234615) is a healthcare organization registered as a mental health (including community mental health center) in Henrico, Virginia and active in the NPI registry since October 2024. The organization lists Jon Frederick, Owner, as its authorized official.

NPPES Registry Identity

NPI1063234615
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameKETAMINE RVA
Location Address8639 MAYLAND DR STE 102Henrico, VA 23294-4752
Mailing Address8639 Mayland Dr Ste 102Henrico, VA 23294-4752
Phone(804) 993-3039
Organization SubpartNo
Authorized OfficialJon FrederickOwner · (804) 993-3039
Enumeration DateOctober 25, 2024
NPPES CertifiedOctober 25, 2024
✔ NPI 1063234615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
8639 MAYLAND DR STE 102, Henrico, VA 23294
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JON RANDALL FREDERICK M.D.
Emergency Medicine
8639 MAYLAND DR STE 102
RICHMOND, VA 23294
Henrico County (804) 993-3039
ALCHEMY PLLC
Clinic/Center (Pain)
8639 MAYLAND DR STE 102
HENRICO, VA 23294
Henrico County (804) 993-3039

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ketamine Rva's NPI number?

The NPI number for Ketamine Rva is 1063234615. It was assigned to this organization in the NPPES registry on October 25, 2024.

Where is Ketamine Rva located?

Ketamine Rva is located at 8639 Mayland Dr Ste 102, Henrico, VA 23294. The listed phone number is (804) 993-3039.

What is Ketamine Rva's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Ketamine Rva was last updated on October 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.