Illuminate Ketamine Center PLLC
NPI 1649833062 · Certified Registered Nurse Anesthetist · Kingsport, TN
Illuminate Ketamine Center PLLC is a Certified Registered Nurse Anesthetist organization in Kingsport, TN (NPI 1649833062).
Provider details
- NPI number
- 1649833062
- Entity type
- Organization
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Shelia Beasley, Co-Owner/ President(423) 765-0777
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Behavioral Health & Social Service Providers
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
- Marriage & Family Therapist106H00000X
Behavioral Health & Social Service Providers
- Infusion Therapy Clinic/Center261QI0500X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
Other names (DBA / former)
- Doing business as
- Illuminate Wellness Center
Registry dates
- Enumerated
- 2019-04-22
- Last updated
- 2021-03-03
- Certified
- 2021-03-03
Frequently asked questions
- What is Illuminate Ketamine Center PLLC's NPI number?
- Illuminate Ketamine Center PLLC's National Provider Identifier (NPI) is 1649833062, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Illuminate Ketamine Center PLLC?
- Illuminate Ketamine Center PLLC is classified in the NPPES registry as Certified Registered Nurse Anesthetist (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Illuminate Ketamine Center PLLC located?
- Illuminate Ketamine Center PLLC's practice location on file with NPPES is 1936 Brookside Dr Ste E, Kingsport, TN 37660-4654.
- What is Illuminate Ketamine Center PLLC's phone number?
- The practice phone number listed in the NPPES registry for Illuminate Ketamine Center PLLC is (423) 765-0777.
- Who is the authorized official for Illuminate Ketamine Center PLLC?
- The authorized official listed on Illuminate Ketamine Center PLLC's NPPES record is Shelia Beasley, Co-Owner/ President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Illuminate Ketamine Center PLLC's NPI active?
- Yes — Illuminate Ketamine Center PLLC's NPI (1649833062) is active in the NPPES registry as of the last update on 2021-03-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.