NPIMap

Organization Active NPI

Medina County Board of Mr/DD

Doing business as MCAC - Medina County Achievement Center

  • Licensed Practical Nurse
  • Medina, OH
National Provider Identifier
1609968213
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
Legal business name
MEDINA COUNTY BOARD OF MR/DD
Doing business as
MCAC - Medina County Achievement Center
Practice address
4691 Windfall Rd
Medina, OH 44256-8705
Phone
(330) 725-7751
Fax
(330) 722-4854
NPI assigned
Sep 29, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mrs. Nancy Coerver
Title
Business Manager
Phone
(330) 725-7751

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Developmentally Disabled Services Day Training Agency 251C00000X NU
Non-emergency Medical Transport (VAN) 343900000X NU
Taxi 344600000X NU
Bus 347B00000X NU
Social Worker 104100000X NU
Day Training/Habilitation Specialist 373H00000X NU
Personal Care Attendant 3747P1801X NU
Registered Nurse 163W00000X NU
Licensed Practical Nurse 164W00000X NU Primary
Occupational Therapy Assistant 224Z00000X NU
Physical Therapist 225100000X NU
Music Therapist 225A00000X NU
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

4691 Windfall Rd
Medina, OH 44256-8705

Mailing address

4691 Windfall Rd
Medina, OH 44256-8705
Phone (330) 725-7751

Other identifiers 2

IdentifierTypeStateIssuer
0671312MedicaidOH
2567306MedicaidOH

Other names 1

  • MCAC - Medina County Achievement Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medina County Health de5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

4691 Windfall Rd
Medina, OH 44256
Phone (330) 725-7751

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1609968213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4691 WINDFALL RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568705",
            "telephone_number": "330-725-7751",
            "fax_number": "330-722-4854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4691 WINDFALL RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568705",
            "telephone_number": "330-725-7751",
            "fax_number": "330-722-4854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDINA COUNTY BOARD OF MR/DD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "COERVER",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "330-725-7751",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "344600000X",
            "taxonomy_group": "",
            "desc": "Taxi",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "347B00000X",
            "taxonomy_group": "",
            "desc": "Bus",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0671312",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2567306",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCAC - Medina County Achievement Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medina, 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.

Verify at the official NPI Registry.