Kevin Douglas Bohannon, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

24548 Issued in TN

Practice address

1068 Cresthaven Rd Ste 150
Memphis, TN 38119-3859

Phone

(901) 682-6828

Fax

(901) 682-9316

NPI assigned

Apr 30, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, SC2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Low Country Anesthesia, PAGroup PAC ID 8729063797, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaufort County Memorial Hospital Hospital, Beaufort, SC, CCN 420067

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Low Country Anesthesia, PA

  • Anesthesiology Physician
  • Beaufort, SC
  • NPI 1417928268
  Medicare reassignment Care Compare group NPD
• East Memphis Anesthesia Services PLC

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1578592663
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Beaufort County Memorial Hospital

  • General Acute Care Hospital
  • Beaufort, SC
  • NPI 1366436073
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1275021891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 CRESTHAVEN RD STE 150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193859",
            "telephone_number": "901-682-6828",
            "fax_number": "901-682-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 CRESTHAVEN RD STE 150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193859",
            "telephone_number": "901-682-6828",
            "fax_number": "901-682-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHANNON",
        "first_name": "KEVIN",
        "middle_name": "DOUGLAS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-30",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "24548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Andrew Boehme, OD
• Mary Boers, CRNA
• Robert Shelton Boger, MD
• Andrea Kaye Boggs, PT, DPT
• Steven Boggs, MD
• Shiva Bohn, MD
• Leah Boice, MFT
• Ruby Boisclair
• Melody Bojang, MFCS, RD, LDN
• Matthew James Bokamper, MD

• Certified Registered Nurse Anesthetist in Memphis, TN
• Providers in Memphis, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.