Individual provider Active NPI

Kendall Jenay Neeriemer, PA-S

  • Physician Assistant
  • Bentonville, AR
National Provider Identifier
1467341453
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3502 NW Riverbend Rd
Bentonville, AR 72712-8275
Phone
(770) 827-3074
NPI assigned
Jul 2, 2025
Last updated
Jan 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

3502 NW Riverbend Rd
Bentonville, AR 72712-8275

Mailing address

3502 NW Riverbend Rd
Bentonville, AR 72712-8275
Phone (770) 827-3074

Other names 1

  • Kendall Jenay Holton Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260209002304 AR Practitioner - Physician Assistant 0042799280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ozark Orthopaedics, P.a.Group PAC ID 2860477189, 57 clinicians

Practice addresses (Care Compare)

3317 N Wimberly Dr
Fayetteville, AR 72703-4056
Phone (479) 521-2752

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ozark Orthopaedics, PA CurrentSince Dec 29, 2025 Accepting new patients
Ozark Orthopaedics, P.a. CurrentSince Dec 29, 2025 Accepting new patients

Locations

1800 SE Moberly Ln
Bentonville, AR 72712
Phone (479) 521-2752

3317 N Wimberly Dr
Fayetteville, AR 72703
Phone (479) 521-2752

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18403/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1751414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1467341453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 NW RIVERBEND RD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727128275",
            "telephone_number": "770-827-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 NW RIVERBEND RD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727128275",
            "telephone_number": "770-827-3074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEERIEMER",
        "first_name": "KENDALL",
        "middle_name": "JENAY",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-02",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDALL",
            "last_name": "HOLTON",
            "middle_name": "JENAY",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.