BOISE KETAMINE CLINIC
NPI 1518547140
Clinic/Center - Infusion Therapy in Boise, ID

Active since April 08, 2021
2800 W OVERLAND RD, BOISE, ID 83705(208) 801-1414(208) 207-2866 Get Directions Write a Review

NPPES record last updated: April 8, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Boise Ketamine Clinic NPPES

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

BOISE KETAMINE CLINIC (NPI 1518547140) is a healthcare organization registered as an infusion therapy in Boise, Idaho and active in the NPI registry since April 2021. The organization lists Nykol Bailey, Owner, as its authorized official.

NPPES Registry Identity

NPI1518547140
Entity TypeOrganization
Primary Taxonomy261QI0500X
Legal Business NameBOISE KETAMINE CLINIC
Location Address2800 W OVERLAND RDBoise, ID 83705-3038
Mailing Address2800 W Overland RdBoise, ID 83705-3038 · (208) 801-1414 · Fax (208) 207-2866
Fax(208) 207-2866
Organization SubpartNo
Authorized OfficialNykol BaileyOwner · (208) 801-1414
Enumeration DateApril 8, 2021
NPPES CertifiedMarch 25, 2021
NPI 1518547140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Infusion TherapyAmbulatory Health Care Facilities
Taxonomy Code261QI0500X
2800 W OVERLAND RD, Boise, ID 83705

Other Providers at the Same Location NPPES 4

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

Internal Medicine (Rheumatology)
2800 W OVERLAND RD
BOISE, ID 83705
Nurse Practitioner (Psychiatric/Mental Health)
2800 W OVERLAND RD
BOISE, ID 83705
Nurse Practitioner (Family)
2800 W OVERLAND RD
BOISE, ID 83705
Clinic/Center (Mental Health (Including Community Mental Health Center))
2800 W OVERLAND RD
BOISE, ID 83705

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 Boise Ketamine Clinic's NPI number?

The NPI number for Boise Ketamine Clinic is 1518547140. It was assigned to this organization in the NPPES registry on April 8, 2021.

Where is Boise Ketamine Clinic located?

Boise Ketamine Clinic is located at 2800 W Overland Rd, Boise, ID 83705. The listed phone number is (208) 801-1414.

What is Boise Ketamine Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Infusion Therapy, with taxonomy code 261QI0500X.

When was this NPI record last updated?

The NPPES record for Boise Ketamine Clinic was last updated on April 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.