ILLUMINATE WELLNESS CENTER
NPI 1649833062
Nurse Anesthetist, Certified Registered in Kingsport, TN

Active since April 22, 2019
1936 BROOKSIDE DR STE E, KINGSPORT, TN 37660(423) 765-0777 Get Directions Write a Review

NPPES record last updated: March 3, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 3, 2021, Feb 2, 2021, Apr 22, 2019 (3 updates tracked since 2019).

About Illuminate Wellness Center NPPES

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

ILLUMINATE WELLNESS CENTER (NPI 1649833062) is a healthcare organization registered as a nurse anesthetist, certified registered in Kingsport, Tennessee and active in the NPI registry since April 2019. The organization lists Shelia Beasley, Co-owner/ President, as its authorized official.

NPPES Registry Identity

NPI1649833062
Entity TypeOrganization
Primary Taxonomy367500000X
Legal Business NameILLUMINATE KETAMINE CENTER PLLC
Location Address1936 BROOKSIDE DR STE EKingsport, TN 37660-4654
Mailing Address1936 Brookside Dr Ste EKingsport, TN 37660-4654 · (423) 765-0777
Organization SubpartNo
Authorized OfficialShelia BeasleyCo-owner/ President · (423) 765-0777
Enumeration DateApril 22, 2019
Last NPPES UpdateMarch 3, 20213 updates tracked since enumeration
NPPES CertifiedMarch 3, 2021
NPI 1649833062 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedMarriage & Family TherapistTaxonomy 106H00000X
Also ListedClinic/Center · Infusion TherapyTaxonomy 261QI0500X
1936 BROOKSIDE DR STE E, Kingsport, TN 37660

Other Names 1

Doing Business AsIlluminate Wellness Center

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

Marriage & Family Therapist
1936 BROOKSIDE DR STE E
KINGSPORT, TN 37660
Clinic/Center (Primary Care)
1936 BROOKSIDE DR STE E
KINGSPORT, TN 37660
Family Medicine
1936 BROOKSIDE DR STE E
KINGSPORT, TN 37660

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 Illuminate Ketamine Center PLLC's NPI number?

The NPI number for Illuminate Ketamine Center PLLC is 1649833062. It was assigned to this organization in the NPPES registry on April 22, 2019. The provider is doing business as Illuminate Wellness Center.

Where is Illuminate Ketamine Center PLLC located?

Illuminate Ketamine Center PLLC is located at 1936 Brookside Dr Ste E, Kingsport, TN 37660. The listed phone number is (423) 765-0777.

What is Illuminate Ketamine Center PLLC's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

When was this NPI record last updated?

The NPPES record for Illuminate Ketamine Center PLLC was last updated on March 3, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.