Jackson Cbmrdd

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

4000011 Issued in OH

Legal business name

JACKSON CBMRDD

Practice address

202 S Pennsylvania Ave
Wellston, OH 45692-1719

Phone

(740) 286-6491

NPI assigned

Mar 29, 2007

Last updated

Jun 15, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicholas Elliott

Title

Superintendent

Phone

(740) 286-6491

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Jackson County Home HLT2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• County of Jackson

  dba Jackson County EMS

  • Land Ambulance
  • Jackson, OH
  • NPI 1851601132
  NPD tax ID

Locations

Practitioners 2

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.

• Amber Nichole Pratt, MA, CCC-SLP

  • Speech-Language Pathologist
  • Jackson, OH
  • NPI 1023176104
  NPD (past)
• Kayleigh Victoria Ross, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Jackson, OH
  • NPI 1306620604
  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781481600000",
    "number": "1255451050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 SELLARS DR",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456402059",
            "telephone_number": "740-286-6491",
            "fax_number": "740-286-6657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S PENNSYLVANIA AVE",
            "city": "WELLSTON",
            "state": "OH",
            "postal_code": "456921719",
            "telephone_number": "740-286-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON CBMRDD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "740-286-6491"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "OH",
            "license": "4000011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0801207",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hopewell Health Centers, Inc.
• Hopewell Health Centers, Inc.
• Hopewell Health Centers, Inc.
• Hannah Lynn Hutchins, COTA/L
• J. Edgar Evans O.D., Inc.
• Jackson County Health Facilities Inc. (Jenkins Care Community)
• Jackson County Health Facilities Inc. (Jenkins Memorial Health Facility)
• Jackson-Vinton Community Action, Inc.
• Lauryn Ruth Johnson
• Douglas R Jones, D.O.

• Developmentally Disabled Services Day Training Agency in Wellston, OH
• Providers in Wellston, OH by specialty
• Developmentally Disabled Services Day Training Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; 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.