NPIMap

Organization Active NPI

BHG Lxxiv, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • West Plains, MO
National Provider Identifier
1710698055
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
Practice address
1639 Bruce Smith Pkwy
West Plains, MO 65775-7691
Phone
(417) 255-6441
Fax
(417) 256-0488
NPI assigned
Dec 7, 2022
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
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

1639 Bruce Smith Pkwy
West Plains, MO 65775-7691

Mailing address

5001 Spring Valley Road
Suite 600 East
Dallas, TX 75244-3946
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
26D2305921BHG Lxxiv, LLC Dba BHG Medical Services - Missouri1639 Bruce Smith Parkway, Obot Room #100, West Plains, MO 65775Certificate 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

1639 Bruce Smith Pkwy
West Plains, MO 65775
Phone (417) 255-6441

Practitioners & affiliated clinicians

Practitioners 19

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

View all 19

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": "1710698055",
    "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": "1639 BRUCE SMITH PKWY",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657757691",
            "telephone_number": "417-255-6441",
            "fax_number": "417-256-0488"
        }
    ],
    "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "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 West Plains, 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.