Active NPI
Perry Kent Bohanon, MSN, APRN, BC
- Nurse Practitioner
- Edgewood, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3002807
- Practice address
- 334 Thomas More Parkway
Edgewood, KY 41017-3464 - Phone
- (859) 301-5901
- Fax
- (859) 301-5940
- NPI assigned
- Dec 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0808X | 3002807 | KY | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 3002807 | KY | |
| Adult Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0809X | 3002807 | KY | |
| Nurse Practitioner | 363L00000X | 3002807 | KY | Primary |
Addresses
Primary practice location
334 Thomas More Parkway
Edgewood, KY 41017-3464
Mailing address
PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 301-5901
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0154352 | Medicaid | OH | |
| 201331790 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1400 Grand Ave
Newport, KY 41071-2570
Phone (859) 912-7193
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.01 of 100
- Quality
- 86.02
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Specialist, Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3002807 | KY | MD | Psychiatric/Mental Health Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group, Inc | Nurse Practitioner | Current | Accepting new patients |
| Summit Medical Group, Inc. | Current | Accepting new patients | |
| Inner Pathways PLLC | Past | Accepting new patients | |
| Positive Directions II LLC | Past | Accepting new patients |
Locations
334 Thomas More Pkwy
Crestview Hills, KY 41017
Phone (859) 331-6065
1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700
1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070
300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217
Interoperability endpoints
- pbohanon186715@direct-prd.stelizabeth.com
Organizations & group practices 4
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.
-
- Foot & Ankle Surgery Podiatrist
- Crestview Hills, KY
- NPI 1043188378
-
- Mental Health Counselor
- Erlanger, KY
- NPI 1225196181
-
- Community/Behavioral Health Agency
- Cynthiana, KY
- NPI 1881736791
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668643200000",
"number": "1467437178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 635283",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452635283",
"telephone_number": "859-301-5901",
"fax_number": "859-301-5940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "334 THOMAS MORE PARKWAY",
"city": "EDGEWOOD",
"state": "KY",
"postal_code": "410173464",
"telephone_number": "859-301-5901",
"fax_number": "859-301-5940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHANON",
"first_name": "PERRY",
"middle_name": "KENT",
"name_prefix": "Mr.",
"credential": "MSN, APRN, BC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-14",
"last_updated": "2022-11-17",
"certification_date": "2022-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "364SP0808X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
"state": "KY",
"license": "3002807",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "KY",
"license": "3002807",
"primary": false
},
{
"code": "364SP0809X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
"state": "KY",
"license": "3002807",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "3002807",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0154352",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201331790",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Edgewood, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.