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LAS VEGAS KETAMINE LLC
NPI 1710696877
Nurse Practitioner - Psychiatric/Mental Health in Las Vegas, NV

Active since November 17, 2022
7390 W SAHARA AVE STE 270, LAS VEGAS, NV 89117(702) 957-0468 Get Directions Write a Review

NPPES record last updated: May 22, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 22, 2026, Mar 6, 2025, Feb 28, 2025 and 1 more (4 updates tracked since 2022).

About Las Vegas Ketamine Llc NPPES

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

LAS VEGAS KETAMINE LLC (NPI 1710696877) is a healthcare organization registered as a psychiatric/mental health in Las Vegas, Nevada and active in the NPI registry since November 2022. The organization lists Adam C Fisher, Owner/manager, as its authorized official.

NPPES Registry Identity

NPI1710696877
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameLAS VEGAS KETAMINE LLC
Location Address7390 W SAHARA AVE STE 270Las Vegas, NV 89117-2765
Mailing Address5519 Bruin Lakes StLas Vegas, NV 89131-5921 · (229) 412-5844
Phone(702) 957-0468
Organization SubpartNo
Authorized OfficialAdam C FisherOwner/manager · (229) 412-5844
Enumeration DateNovember 17, 2022
Last NPPES UpdateMay 22, 20264 updates tracked since enumeration
NPPES CertifiedMay 22, 2026
✔ NPI 1710696877 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Also ListedAnesthesiologyTaxonomy 207L00000X
7390 W SAHARA AVE STE 270, Las Vegas, NV 89117
Open in Google Maps ↗

Other Identifiers 1

Other1407158694Tricare West

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Las Vegas Ketamine Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Las Vegas Ketamine LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Richard Bennett, MD
Anesthesiology
NPI 1699112185
7390 W SAHARA AVE STE 270
Las Vegas, NV 89117
(970) 396-3089
✔ PECOS✔ Accepts MedicareSame address
Nipaporn Buadaeng, APRN
Nurse Practitioner
NPI 1366939019
3425 CLIFF SHADOWS PKWY STE 250
Las Vegas, NV 89129
(702) 382-1599
✔ PECOS✔ Accepts Medicare6.9 mi

Source: 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 Las Vegas Ketamine LLC's NPI number?

The NPI number for Las Vegas Ketamine LLC is 1710696877. It was assigned to this organization in the NPPES registry on November 17, 2022.

Where is Las Vegas Ketamine LLC located?

Las Vegas Ketamine LLC is located at 7390 W Sahara Ave Ste 270, Las Vegas, NV 89117. The listed phone number is (702) 957-0468.

What is Las Vegas Ketamine LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Las Vegas Ketamine LLC enrolled in Medicare?

Yes. Las Vegas Ketamine LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Las Vegas Ketamine LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Las Vegas Ketamine LLC, in Anesthesiology and Nurse Practitioner. 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. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Las Vegas Ketamine LLC accept?

Health plans from Molina Healthcare list Las Vegas Ketamine LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Las Vegas Ketamine LLC was last updated on May 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.