Active NPI
Trumbull County Board of MRDD
- Case Management Agency
- Niles, OH
National Provider Identifier
1053435172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- Legal business name
- TRUMBULL COUNTY BOARD OF MRDD
- Practice address
- 45 North Rd
Niles, OH 44446-1918 - Phone
- (330) 652-9800
- Fax
- (330) 652-1345
- NPI assigned
- Mar 16, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Douglas A. Burkhardt, PHD
- Title
- Superintendent
- Phone
- (330) 652-9800
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | Primary | ||
| Developmentally Disabled Services Day Training Agency | 251C00000X |
Addresses
Primary practice location
45 North Rd
Niles, OH 44446-1918
Mailing address
45 North Rd
Niles, OH 44446-1918
Phone (330) 652-9800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2567502 | Medicaid | OH |
National Provider Directory
National Provider Directory- Tax ID family
- Trumbull County Board of MRDD
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adolescent and Children Mental Health Clinic/Center
- Warren, OH
- NPI 1508379314
-
- Public Health or Welfare Agency
- Cortland, OH
- NPI 1326230814
-
- In Home Supportive Care Agency
- Warren, OH
- NPI 1922416734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1053435172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 NORTH RD",
"city": "NILES",
"state": "OH",
"postal_code": "444461918",
"telephone_number": "330-652-9800",
"fax_number": "330-652-1345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 NORTH RD",
"city": "NILES",
"state": "OH",
"postal_code": "444461918",
"telephone_number": "330-652-9800",
"fax_number": "330-652-1345"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRUMBULL COUNTY BOARD OF MRDD",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-16",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "BURKHARDT",
"authorized_official_first_name": "DOUGLAS",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "SUPERINTENDENT",
"authorized_official_telephone_number": "330-652-9800",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": true
},
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2567502",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Niles, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.