Organization Active NPI

Vcphcs XV, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Joplin, MO
National Provider Identifier
1144666264
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
1305-3 Issued in MO
Legal business name
VCPHCS XV, LLC
Practice address
2919 E 4TH St
Joplin, MO 64801-1625
Phone
(417) 782-7966
Fax
(417) 624-4558
NPI assigned
May 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Authorized official

Name
Jay Higham
Title
Ceo
Phone
(214) 365-6112

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Methadone Clinic 261QM2800X 1305-3 MO
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 1305-3 MO Primary

Addresses

Primary practice location

2919 E 4TH St
Joplin, MO 64801-1625

Mailing address

5001 Spring Valley Road
Suite 600 East
Dallas, TX 75244-3946
Phone (214) 365-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151016001032 MO Part B Supplier - Clinic/Group Practice 4486963345 Receives reassigned benefits from 11 practitioners
Practice locations: Jolin, MO
O20191220001818 MO Part B Supplier - Opioid Treatment Program (Otp) 4486963345 Practice locations: Joplin, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2002164Vcphcs XV, LLC Dba BHG Joplin Treatment Center2919 East 4TH Street, Joplin, MO 64801Certificate of waiverJan 7, 2028

National Provider Directory

National Provider Directory

Locations

2919 E 4th St
Joplin, MO 64801
Phone (417) 782-7966

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735257600000",
    "number": "1144666264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 SPRING VALLEY ROAD",
            "address_2": "SUITE 600 EAST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443946",
            "telephone_number": "214-365-6100",
            "fax_number": "214-365-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 E 4TH ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648011625",
            "telephone_number": "417-782-7966",
            "fax_number": "417-624-4558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VCPHCS XV, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-15",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A",
        "authorized_official_last_name": "HIGHAM",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-365-6112"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "MO",
            "license": "1305-3",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MO",
            "license": "1305-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.