BHG Lxxxvii, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

BHG LXXXVII, LLC

Doing business as

BHG Medical Services - Idaho

Practice address

92 S Cole Rd
Obot Room #100
Boise, ID 83709-0930

Phone

(208) 376-5021

Fax

(208) 376-5020

NPI assigned

Nov 30, 2022

Last updated

Sep 23, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Zack Ragsdale

Title

Director

Phone

(512) 454-5911

Specialties & licenses 3

Addresses

Other names 1

• BHG Medical Services - Idaho Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• BHG Lxxxvii, LLC

  dba BHG Medical Services - Idaho

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Coeur d'Alene, ID
  • NPI 1235844820

  O20230829002579

  Same enrollment
• BHG Lxxxvii, LLC

  dba BHG Medical Services - Idaho

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Meridian, ID
  • NPI 1770298465

  O20230829002579

  Same enrollment

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

CLIA laboratory certificates

Tax ID family

BHG Lxxxvii LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• BHG Lxxxvii, LLC

  dba BHG Medical Services - Idaho

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Meridian, ID
  • NPI 1770298465
  NPD tax ID

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vincent Marchese, NP-C, PMHNP-BC

  • Nurse Practitioner
  • Coeur d'Alene, ID
  • NPI 1831847383
  Medicare reassignment NPD (past)
• Melissa Adele Wren Perry, NP

  • Gerontology Nurse Practitioner
  • Boise, ID
  • NPI 1902459266
  Medicare reassignment
• Cynthia Diane Jones, APRN-CNP

  • Adult Health Nurse Practitioner
  • Lehi, UT
  • NPI 1710564125
  NPD (past)

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

{
    "created_epoch": "1669766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1194435123",
    "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": "92 S COLE RD",
            "address_2": "OBOT ROOM #100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837090930",
            "telephone_number": "208-376-5021",
            "fax_number": "208-376-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BHG LXXXVII, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-30",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "RAGSDALE",
        "authorized_official_first_name": "ZACK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "512-454-5911"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BHG Medical Services - Idaho",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Frances Bevill, LPC
• Carolyn Maria Bevington
• Beyond Wellness PLLC
• Julianne Bhak
• BHC Intermountain Hospital, Inc.
• Timothy A Bialobrzeski, D.O.
• Ryan Douglas Bibler, MD
• Kimberly L Bickley Lee, LCSW
• Mary Katherine Biddle-Newberry
• Michael Alfred Biddle Jr., PHARM.D., BCPS

• Substance Use Disorder Rehabilitation Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.