Cynthia Lynn Hollis-Keene, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2015003170 Issued in MO

Practice address

10520 W Farm Road 60
Walnut Grove, MO 65770-2825

Phone

(417) 268-7952

Fax

(417) 886-2774

NPI assigned

Feb 23, 2010

Last updated

Oct 10, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO, KS, WA3 enrollments

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 3

Specialty

Nurse Practitioner

Education

University of Kansas School of Med (KC/Wich/Sal), 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kitsap Mental Health ServicesGroup PAC ID 2961391875, 9 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kitsap Mental Health Services

  • Community/Behavioral Health Agency
  • Bremerton, WA
  • NPI 1033268008
  Medicare reassignment Care Compare group NPD
• Forefront-Rosenzweig Medical Services Professional Corporation

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1588101745

  KS

  Medicare reassignment NPD
• Ho-Ke and Company LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Walnut Grove, MO
  • NPI 1730947037
  Authorized official Same address or phone
• Lester E Cox Medical Centers

  dba Coxhealth Center Willow Springs

  • Family Medicine Physician
  • Willow Springs, MO
  • NPI 1417122326
  NPD (past)
• Lester E Cox Medical Centers

  dba CoxHealth Springfield Inpatient Physicians

  • Hospitalist Physician
  • Springfield, MO
  • NPI 1902969272
  NPD (past)

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

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1396067906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10520 W FARM ROAD 60",
            "city": "WALNUT GROVE",
            "state": "MO",
            "postal_code": "657702825",
            "telephone_number": "417-268-7952",
            "fax_number": "417-886-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10520 W FARM ROAD 60",
            "city": "WALNUT GROVE",
            "state": "MO",
            "postal_code": "657702825",
            "telephone_number": "417-268-7952",
            "fax_number": "417-886-2774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1540 E Evergreen St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658034300",
            "country_code": "US",
            "telephone_number": "417-823-2900",
            "fax_number": "417-886-2774",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 E Bradford Pkwy",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658044264",
            "country_code": "US",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLIS-KEENE",
        "first_name": "CYNTHIA",
        "middle_name": "LYNN",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-23",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "154542",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2015003170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396067906",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Sue Allen
• Dakota Burnett, OTR/L
• Ho-Ke and Company LLC
• Steadfast Counseling Services, LLC
• Walnut Grove School Dist R5

• Psychiatric/Mental Health Nurse Practitioner in Walnut Grove, MO
• Providers in Walnut Grove, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.