IKC, LLC
NPI 1659904803
Clinic/Center in West Des Moines, IA
About Ikc, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IKC, LLC (NPI 1659904803), doing business as Iowa Ketamine Clinic, is a healthcare organization registered as a clinic/center in West Des Moines, Iowa and active in the NPI registry since February 2020. The organization maintains a secondary practice location in Ankeny and lists Julie Otten, Revenue Cycle Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Secondary Practice Location 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ikc, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
21Medicare enrollment records show 21 clinicians reassign Medicare billing to Ikc, LLC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 10 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 4
Nearest to this location (20)
See all 21Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Ikc, LLC's NPI number?
The NPI number for Ikc, LLC is 1659904803. It was assigned to this organization in the NPPES registry on February 17, 2020. The provider is doing business as Iowa Ketamine Clinic.
Where is Ikc, LLC located?
Ikc, LLC is located at 1701 48th St Ste 260, West Des Moines, IA 50266. The listed phone number is (515) 401-4774.
What is Ikc, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is Ikc, LLC enrolled in Medicare?
Yes. Ikc, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Ikc, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 21 clinicians in 4 Medicare specialties reassign their Medicare billing to Ikc, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (10), Certified Registered Nurse Anesthetist (CRNA) (9) and Marriage and Family Therapist (1). Of these, 5 practice at this address and 10 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Ikc, LLC was last updated on October 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Ikc, Llc · NPI 1659904803
Clinic/Center organization in West Des Moines, Iowa. Organization record, active in the CMS NPPES registry since February 17, 2020.
## Identity
- **NPI:** 1659904803 (Entity type: Organization)
- **Enumerated:** February 17, 2020
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Also known as:** Iowa Ketamine Clinic (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Julie Otten, REVENUE CYCLE DIRECTOR
## Practice location
- **Address:** 1701 48TH ST STE 260, West Des Moines, IA 50266-6726
- **Phone:** (515) 401-4774 · **Fax:** (515) 254-3092
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 21 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (10), Certified Registered Nurse Anesthetist (CRNA) (9), Marriage and Family Therapist (1); 5 practice at this address and 10 within 10 miles; [full list](https://npiprofile.com/npi/1659904803/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 5, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1659904803) · Data from the CMS NPPES public registry.