Organization Active NPI

BHG Lxxiv, LLC

Doing business as BHG Medical Services - Missouri

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Poplar Bluff, MO
National Provider Identifier
1629789961
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
BHG LXXIV, LLC
Doing business as
BHG Medical Services - Missouri
Practice address
1369 N Westwood Blvd Ste C
Poplar Bluff, MO 63901-3313
Phone
(573) 722-7937
Fax
(573) 785-0346
NPI assigned
Dec 7, 2022
Last updated
Dec 26, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BHG LXXIV, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 26, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

1369 N Westwood Blvd Ste C
Poplar Bluff, MO 63901-3313

Mailing address

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

Other names 1

  • BHG Medical Services - Missouri Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230718001201 MO Part B Supplier - Clinic/Group Practice 8527428861 Receives reassigned benefits from 15 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbia, MO; Joplin, MO; Kansas City, MO; Poplar Bluff, MO; Springfield, MO; West Plains, MO

Other NPIs on the same Medicare enrollment 6

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

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
26D2305869BHG Lxxiv, LLC D/B/a BHG Medical Services -1369 North Westwood Blvd, Ste C, Obot Room 100, Poplar Bluff, MO 63901Certificate of waiverJun 6, 2028

National Provider Directory

National Provider Directory
Tax ID family
BHG Lxxiv LLC7 organizations share this tax ID, including this one
Part of
BHG Lxxiv LLC

Other organizations with this tax ID 6

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

Locations

1369 N Westwood Blvd
Ste C
Poplar Bluff, MO 63901
Phone (573) 722-7937

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735171200000",
    "number": "1629789961",
    "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": "75244",
            "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": "1369 N WESTWOOD BLVD STE C",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013313",
            "telephone_number": "573-722-7937",
            "fax_number": "573-785-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BHG LXXIV, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BHG LXXIV, LLC",
        "enumeration_date": "2022-12-07",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "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": "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 - Missouri",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BHG Medical Services - Missouri",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.