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Revive Ketamine Clinic, Pllc

Medical Specialty Clinic/Center in Bartlett, TN · enumerated 2021 · authorized official Ginger Williams, Owner/Practitioner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1053984484

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Registry record

Entity type Organization (Type 2)
Legal business name Revive Ketamine Clinic, Pllc
Practice address 5820 Stage Rd, Bartlett, TN, 38134
Phone (901) 317-7900
Fax (901) 317-7899
Enumeration date Jul 22, 2021
Last updated in NPPES Apr 15, 2024

Taxonomy & classification

261QM2500X Medical Specialty Clinic/Center Ambulatory Health Care Facilities Primary
363LP0808X Psychiatric/Mental Health Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Secondary

Authorized official

Name Ginger Williams
Title Owner/Practitioner
Phone (901) 317-7900

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Revive Ketamine Clinic, Pllc?
Revive Ketamine Clinic, Pllc is registered in NPPES as a Medical Specialty Clinic/Center (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-04-15.