865 WELLNESS KETAMINE LLC
NPI 1912696808
Nurse Anesthetist, Certified Registered in Knoxville, TN

Q: What is 865 Wellness Ketamine LLC's NPI number?

The NPI number for 865 Wellness Ketamine LLC is 1912696808. It was assigned to this organization in the NPPES registry on May 5, 2023.

Q: What is 865 Wellness Ketamine LLC's specialty?

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

Active since May 05, 2023

601 S CONCORD ST STE 100, KNOXVILLE, TN 37919(865) 805-3118(865) 415-2841 Get Directions Write a Review

NPPES record last updated: July 23, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

On this page

About 865 Wellness Ketamine Llc NPPES

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

865 WELLNESS KETAMINE LLC (NPI 1912696808) is a healthcare organization registered as a nurse anesthetist, certified registered in Knoxville, Tennessee and active in the NPI registry since May 2023. The organization lists Jennifer Watson, Owner, as its authorized official.

NPPES Registry Identity

NPI1912696808

Entity TypeOrganization

Primary Taxonomy367500000X

Legal Business Name865 WELLNESS KETAMINE LLC

Location Address601 S CONCORD ST STE 100Knoxville, TN 37919-3339

Mailing Address601 S Concord St Ste 100Knoxville, TN 37919-3339 · (865) 805-3118 · Fax (865) 415-2841

Phone(865) 805-3118

Fax(865) 415-2841

Organization SubpartNo

Authorized OfficialJennifer WatsonOwner · (865) 223-2468

Enumeration DateMay 5, 2023

Last NPPES UpdateJuly 23, 2025

NPPES CertifiedJuly 23, 2025

✔ NPI 1912696808 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.

601 S CONCORD ST STE 100, Knoxville, TN 37919

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to 865 Wellness Ketamine LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jennifer Watson, CRNA

Certified Registered Nurse Anesthetist (CRNA)

NPI 1346677994

601 S CONCORD ST STE 100
Knoxville, TN 37919

(865) 805-3118

Same address

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 865 Wellness Ketamine LLC's NPI number?

The NPI number for 865 Wellness Ketamine LLC is 1912696808. It was assigned to this organization in the NPPES registry on May 5, 2023.

Where is 865 Wellness Ketamine LLC located?

865 Wellness Ketamine LLC is located at 601 S Concord St Ste 100, Knoxville, TN 37919. The listed phone number is (865) 805-3118.

What is 865 Wellness Ketamine LLC's specialty?

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

Is 865 Wellness Ketamine LLC enrolled in Medicare?

Yes. 865 Wellness Ketamine LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through 865 Wellness Ketamine LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Certified Registered Nurse Anesthetist (CRNA)) reassigns their Medicare billing to 865 Wellness Ketamine 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for 865 Wellness Ketamine LLC was last updated on July 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.