NPIMap

Organization Active NPI

Brightview LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Covington, KY
National Provider Identifier
1710672019
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
Legal business name
BRIGHTVIEW LLC
Practice address
1612 Madison Ave
Covington, KY 41011-3318
Phone
(833) 510-4357
Fax
(513) 873-1567
NPI assigned
Apr 11, 2023
Last updated
Apr 11, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
BRIGHTVIEW LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Authorized official

Name
Amy Marie Nieman
Title
Dir of Credentialing & Enrollment
Phone
(513) 834-7063

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU
Addiction Medicine (Internal Medicine) Physician 207RA0401X NU Primary

Addresses

Primary practice location

1612 Madison Ave
Covington, KY 41011-3318

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Brightview LLC28 organizations share this tax ID, including this one
Part of
Brightview LLC

Other organizations with this tax ID 27

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

View all 27

Locations

1612 Madison Ave
Covington, KY 41011

NPI Registry JSON

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1710672019",
    "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": "1612 MADISON AVE",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410113318",
            "telephone_number": "833-510-4357",
            "fax_number": "513-873-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTVIEW LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIGHTVIEW LLC",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "NIEMAN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIR OF CREDENTIALING & ENROLLMENT",
        "authorized_official_telephone_number": "513-834-7063"
    },
    "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": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.