Keith Allen Bohannon, APRN

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

232468 Issued in AR

Practice address

2707 SE G St
Bentonville, AR 72712-3740

Phone

(479) 367-2552

Fax

(479) 367-2584

NPI assigned

May 21, 2025

Sex

Male

Sole proprietor

Yes

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 AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Holden Psychiatric Institute PAGroup PAC ID 9234114349, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Holden Psychiatric Institute, PA

  • Psychiatry Physician
  • Bentonville, AR
  • NPI 1205001088
  Medicare reassignment Care Compare group NPD
• Holden Psychiatric Institute, PA

  • Psychiatry Physician
  • Bentonville, AR
  • NPI 1891230835
  NPD

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1295527596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 SE G ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123740",
            "telephone_number": "479-367-2552",
            "fax_number": "479-367-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 SE G ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123740",
            "telephone_number": "479-367-2552",
            "fax_number": "479-367-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHANNON",
        "first_name": "KEITH",
        "middle_name": "ALLEN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "AR",
            "license": "232468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bloom Speech Therapy
• Anna Bobo
• Bockelman Counseling LLC
• Joy R Bogart
• Holly Bohannan, CRNA MSNA
• Maria Bojanowska
• Sara Elizabeth Bojie, LPC, PMH-C
• Bokker Healthcare LLC
• Paige Boles, APN
• James Ray Bond, P.D.

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.