Corridor Ketamine LLC
NPI 1356099154 · Certified Registered Nurse Anesthetist · Coralville, IA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1356099154
- Entity type
- Organization
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Jennifer Sassman, Arnp/Credentialing(319) 337-8329
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Family Nurse Practitioner363LF0000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (2)
- 5107 Utica Ridge RdDavenport, IA 52807-3062Phone: (319) 337-8329
- 1740 Lininger LnNorth Liberty, IA 52317-2322Phone: (319) 337-8329
Registry dates
- Enumerated
- 2022-03-11
- Last updated
- 2025-06-19
- Certified
- 2025-06-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.