STEPHANIE L BOHANNON (PMHNP, APRN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1104459114
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,410 NURSE PRACTITIONER in AR
Provider Addresses for STEPHANIE L BOHANNON (PMHNP, APRN)
4517 W DIVIDE DR
FAYETTEVILLE, AR 727044020
Phone: (479) 301-5550
Type: Mailing
112 W CENTER ST STE 201
FAYETTEVILLE, AR 727016073
Phone: (479) 316-7770
Type: Location
105 N Mill Ave
Fayetteville, AR 727014273
Phone: (479) 713-8350
Fax: (479) 713-8375
Type: Location
2566 E JOYCE BLVD STE 2
FAYETTEVILLE, AR 727033923
Phone: (479) 935-1000
Fax: (417) 350-1935
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 223 Open Payments records for all available years, with a total value of $12,733.
Total Amount is formed as General ($12,733) + Research ($0) + Ownership ($0) = $12,733.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Axsome Therapeutics, Inc. ($9,138).
Total Amount
$12,733
General + Research + Ownership
Payments
223
Total payment records
General Amount
$12,733
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Axsome Therapeutics, Inc. | $9,138 |
| Corium, LLC | $565 |
| ABBVIE INC. | $491 |
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $402 |
| ITI, Inc. | $319 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-12-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20201229000043 | I | Nurse Practitioner | AR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 87 | 14 | $0 |
Insurance plans in this area (ZIP 72704)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AR | |
| Psychiatry, Addiction Medicine | AR | |
| Nurse Practitioner | AR | |
| Clinical Social Worker | AR | |
| Nurse Practitioner | AR | |
| Nurse Practitioner | AR | |
| Clinical Social Worker | AR | |
| Nurse Practitioner | MO | |
| Mental Health Counselor | AR | |
| Nurse Practitioner | AR |
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