NPIMap

Organization Active NPI

Brightview LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Georgetown, OH
National Provider Identifier
1134724404
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
Legal business name
BRIGHTVIEW LLC
Practice address
421 Home St
Georgetown, OH 45121-1407
Phone
(513) 834-7063
Fax
(513) 873-1567
NPI assigned
Dec 3, 2020
Last updated
May 6, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BRIGHTVIEW LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Authorized official

Name
Amy Marie Nieman
Title
Director
Phone
(833) 510-4357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0401X Primary

Addresses

Primary practice location

421 Home St
Georgetown, OH 45121-1407

Mailing address

4600 Montgomery Rd Ste 400
Cincinnati, OH 45212-2600
Phone (833) 510-4357

Other identifiers 1

IdentifierTypeStateIssuer
7100707910MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Brightview28 organizations share this tax ID, including this one
Part of
Brightview

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1134724404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MONTGOMERY RD STE 400",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122600",
            "telephone_number": "833-510-4357",
            "fax_number": "866-460-2997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 HOME ST",
            "city": "GEORGETOWN",
            "state": "OH",
            "postal_code": "451211407",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTVIEW LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIGHTVIEW LLC",
        "enumeration_date": "2020-12-03",
        "last_updated": "2024-05-06",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "NIEMAN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "833-510-4357"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100707910",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.