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KEITH ALLEN BOHANNON APRN
NPI 1295527596
Clinical Nurse Specialist - Psychiatric/Mental Health, Adult in Bentonville, AR

Active since May 21, 2025PECOS Enrolled
2707 SE G ST, BENTONVILLE, AR 72712(479) 367-2552(479) 367-2584 Get Directions Write a Review

NPPES record last updated: May 21, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Keith Allen Bohannon Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEITH ALLEN BOHANNON APRN (NPI 1295527596) is an individual psychiatric/mental health, adult provider in Bentonville, Arkansas, licensed in Arkansas (232468) and active in the NPI registry since May 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1295527596
Entity TypeIndividualMale
Primary Taxonomy364SP0809X
Provider Legal NameKEITH ALLEN BOHANNONCredential: APRN
Location Address2707 SE G STBentonville, AR 72712-3740
Mailing Address2707 Se G StBentonville, AR 72712-3740 · (479) 367-2552 · Fax (479) 367-2584
Phone(479) 367-2552
Fax(479) 367-2584
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateMay 21, 2025
NPPES CertifiedMay 21, 2025
✔ NPI 1295527596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical Nurse Specialist · Psychiatric/Mental Health, AdultPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code364SP0809X
License✔ Licensed in AR · 232468
2707 SE G ST, Bentonville, AR 72712
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Keith Allen Bohannon Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2668965757
PECOS Enrollment IDI20260106002851
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Keith Bohannon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Holden Psychiatric Institute, PA
Same address
Psychiatry
2707 SE G ST
Bentonville, AR 72712
  • Reassigned Medicare billing, Arkansas enrollment
  • 7 clinicians in this Medicare group
NPI 1205001088 (147) 936-7255

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72712 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$119.36 typical visit price
range $51.36 – $157.74
Typical copayment $29.84 (range $12.84 – $39.43)
Most-billed visit code 99204
Established Patient
$91.63 typical visit price
range $16.16 – $128.77
Typical copayment $22.90 (range $4.04 – $32.19)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOLDEN PSYCHIATRIC INSTITUTE, PA
Psychiatry & Neurology (Psychiatry)
2707 SE G ST
BENTONVILLE, AR 72712
Benton County (147) 936-7255
MRS. WANDA RODINSKY LCSW
Social Worker
2707 SE G ST
BENTONVILLE, AR 72712
Benton County (479) 367-2552
HOLDEN PSYCHIATRIC INSTITUTE, PA
Psychiatry & Neurology (Psychiatry)
2707 SE G ST
BENTONVILLE, AR 72712
Benton County (479) 367-2552
DONNIE JOE HOLDEN M.D.
Psychiatry & Neurology (Psychiatry)
2707 SE G ST
BENTONVILLE, AR 72712
Benton County (479) 367-2552
ADONIA HOLDEN-DUNIVAN LPC
Counselor (Professional)
2707 SE G ST
BENTONVILLE, AR 72712
Benton County (479) 367-2552

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keith Bohannon's NPI number?

The NPI number for Keith Bohannon is 1295527596. It was assigned to this individual provider in the NPPES registry on May 21, 2025.

Where is Keith Bohannon located?

Keith Bohannon practices at 2707 SE G St, Bentonville, AR 72712. The listed phone number is (479) 367-2552.

What is Keith Bohannon's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist, specializing in Psychiatric/Mental Health, Adult, with taxonomy code 364SP0809X.

Is Keith Bohannon enrolled in Medicare?

Yes. Keith Bohannon is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Keith Bohannon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Keith Bohannon reassigns Medicare benefits to Holden Psychiatric Institute, PA (Bentonville, AR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Keith Bohannon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Keith Bohannon accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 1 other insurer list Keith Bohannon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Keith Bohannon was last updated on May 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.