REVIVE KETAMINE AND WELLNESS PC
NPI 1841146214
Clinic/Center - Health Service in Lafayette, IN

Q: What is Revive Ketamine And Wellness PC's NPI number?

The NPI number for Revive Ketamine And Wellness PC is 1841146214. It was assigned to this organization in the NPPES registry on March 9, 2026.

Q: What is Revive Ketamine And Wellness PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

Active since March 09, 2026

210 MEIJER DR STE C, LAFAYETTE, IN 47905(765) 764-9305 Get Directions Write a Review

NPPES record last updated: March 9, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Revive Ketamine And Wellness Pc NPPES

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

REVIVE KETAMINE AND WELLNESS PC (NPI 1841146214) is a healthcare organization registered as a health service in Lafayette, Indiana and active in the NPI registry since March 2026. The organization lists Nicholas George Sansone, Dr, as its authorized official.

NPPES Registry Identity

NPI1841146214

Entity TypeOrganization

Primary Taxonomy261QH0100X

Legal Business NameREVIVE KETAMINE AND WELLNESS PC

Location Address210 MEIJER DR STE CLafayette, IN 47905-4694

Mailing Address3040 Lake Shore DrMichigan City, IN 46360-1708 · (773) 208-5872

Phone(765) 764-9305

Organization SubpartNo

Authorized OfficialNicholas George SansoneDr · (773) 208-5872

Enumeration DateMarch 9, 2026

NPPES CertifiedMarch 9, 2026

✔ NPI 1841146214 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities

Taxonomy Code261QH0100X

210 MEIJER DR STE C, Lafayette, IN 47905

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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 Revive Ketamine And Wellness PC's NPI number?

The NPI number for Revive Ketamine And Wellness PC is 1841146214. It was assigned to this organization in the NPPES registry on March 9, 2026.

Where is Revive Ketamine And Wellness PC located?

Revive Ketamine And Wellness PC is located at 210 Meijer Dr Ste C, Lafayette, IN 47905. The listed phone number is (765) 764-9305.

What is Revive Ketamine And Wellness PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

When was this NPI record last updated?

The NPPES record for Revive Ketamine And Wellness PC was last updated on March 9, 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.