NPIMap

Organization Active NPI

BHG Lviii, LLC

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Louisville, KY
National Provider Identifier
1710727367
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
Legal business name
BHG LVIII, LLC
Practice address
1402 Browns Lane
Suite a, Obot Room 100
Louisville, KY 40207
Phone
(502) 894-0234
NPI assigned
May 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 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 7

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X
Addiction Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0401X
Addiction Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083A0300X
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A0401X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1402 Browns Lane
Suite a, Obot Room 100
Louisville, KY 40207

Mailing address

5001 Spring Valley Rd Ste 600
Dallas, TX 75244-3946
Phone (214) 365-6100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221114002932 KY Part B Supplier - Clinic/Group Practice 4284002783 Receives reassigned benefits from 28 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Berea, KY; Bowling Green, KY; Corbin, KY; Elizabethtown, KY; Frankfort, KY; Hazard, KY; Lexington, KY; Louisville, KY…

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory
Tax ID family
BHG Lviii LLC20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Locations

1402 Browns Ln
#A
Louisville, KY 40207
Phone (502) 894-0234

Practitioners & affiliated clinicians

Practitioners 2

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

  • Kenneth J Payne, M.D.
    • Obstetrics & Gynecology Physician
    • Louisville, KY
    • NPI 1518079649

    Addiction Medicine

    NPD
  • Faryal Khan, MD
    • Addiction Medicine (Family Medicine) Physician
    • Fort Wayne, IN
    • NPI 1811557556

    Addiction Medicine

    NPD

NPI Registry JSON

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1710727367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 SPRING VALLEY RD STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443946",
            "telephone_number": "214-365-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 BROWNS LANE",
            "address_2": "SUITE A, OBOT ROOM 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40207",
            "telephone_number": "502-894-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BHG LVIII, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "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": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "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 Sep 27, 2024; 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.