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Illuminate Ketamine Center Pllc

Certified Registered Nurse Anesthetist in Kingsport, TN · enumerated 2019 · authorized official Shelia Beasley, Co-Owner/ President.

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

National Provider Identifier

1649833062

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Registry record

Entity type Organization (Type 2)
Legal business name Illuminate Ketamine Center Pllc
Other name <Unavail>
Practice address 1936 Brookside Dr Ste E, Kingsport, TN, 37660
Phone (423) 765-0777
Enumeration date Apr 22, 2019
Last updated in NPPES Mar 3, 2021

Taxonomy & classification

101YA0400X Addiction (Substance Use Disorder) Counselor Behavioral Health & Social Service Providers Secondary
101YM0800X Mental Health Counselor Behavioral Health & Social Service Providers Secondary
106H00000X Marriage & Family Therapist Behavioral Health & Social Service Providers Secondary
261QI0500X Infusion Therapy Clinic/Center Ambulatory Health Care Facilities Secondary
367500000X Certified Registered Nurse Anesthetist Physician Assistants & Advanced Practice Nursing Providers Primary

Authorized official

Name Shelia Beasley
Title Co-Owner/ President
Phone (423) 765-0777

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

Where is Illuminate Ketamine Center Pllc located?
The practice location on file with NPPES is in Kingsport, TN.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2021-03-03. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2021-03-03.