Ketamine Ok LLC
Ketamine Ok LLC is a healthcare organization registered as Psychiatry Physician in Moore, OK, holding Type 2 (organization) NPI 1649738865 since 2019. The authorized official on file is Julie Dudley, Practice Manager.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1649738865 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Ketamine Ok LLC |
| Practice address | 1105 SW 30TH CT, Moore, OK, 73160 |
| Phone | 4057030937 |
| Fax | 4053782776 |
| Enumeration date | 2019-03-06 |
| Last updated in NPPES | 2019-03-06 |
Authorized official
| Name | Julie Dudley |
|---|---|
| Title | Practice Manager |
| Phone | 4057030937 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 2084P0800X | Psychiatry Physician | Primary | — | — |
Copy-ready billing details
Provider: Ketamine Ok LLC NPI: 1649738865 Taxonomy: 2084P0800X (Psychiatry Physician) Address: 1105 SW 30TH CT, Moore, OK, 73160
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1073613782 | James Bruner | Individual | Professional Counselor | Moore, OK |
| 1841450855 | Patrick Horn | Individual | Psychiatry Physician | Moore, OK |
| 1114188232 | Cassandra Gentry | Individual | Physician Assistant | Moore, OK |
| 1235456740 | Amy Merrell | Individual | Professional Counselor | Moore, OK |
| 1811218803 | Rachel Dalthorp | Individual | Psychiatry Physician | Moore, OK |
| 1063718658 | Cheri Cantrell-Mccoy | Individual | Mental Health Counselor | Moore, OK |
| 1962796482 | Miranda Friedman | Individual | Clinical Social Worker | Moore, OK |
| 1598039455 | Leslie Warcup | Individual | Obstetrics & Gynecology Nurse Practitioner | Moore, OK |
Verify this record
Cross-check NPI 1649738865 against the authoritative CMS record: view Ketamine Ok LLC on the official NPPES registry .
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. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Ketamine Ok LLC?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2019-03-06.