NPIMap

Organization Active NPI

Sage Support Services

  • Community/Behavioral Health Agency
  • Louisville, KY
National Provider Identifier
1639423577
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SAGE SUPPORT SERVICES
Practice address
11121 Blade Crest Way
Louisville, KY 40291-5076
Phone
(502) 435-9226
NPI assigned
Oct 30, 2012
Last updated
May 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

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

Authorized official

Name
Mark NeeseNPI 1821316613
Title
Member
Phone
(502) 435-9226

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

11121 Blade Crest Way
Louisville, KY 40291-5076

Mailing address

11121 Blade Crest Way
Louisville, KY 40291-5076
Phone (502) 435-9226

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241204002646 KY Part B Supplier - Clinic/Group Practice 2365775897 Receives reassigned benefits from 2 practitioners
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Locations

8910 Greeneway Commons Pl
Ste 100
Louisville, KY 40220
Phone (502) 377-4814

Practitioners & affiliated clinicians

Practitioners 4

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": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558396800000",
    "number": "1639423577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11121 BLADE CREST WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402915076",
            "telephone_number": "502-435-9226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11121 BLADE CREST WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402915076",
            "telephone_number": "502-435-9226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2019-05-21",
        "status": "A",
        "authorized_official_last_name": "NEESE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "502-435-9226"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.