NPIMap

Organization Active NPI

Montgomery County Board of Mr/DD

  • Developmentally Disabled Services Day Training Agency
  • Dayton, OH
National Provider Identifier
1730278441
Registry record updated Apr 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
MONTGOMERY COUNTY BOARD OF MR/DD
Practice address
5450 Salem Ave
Dayton, OH 45426-1450
Phone
(937) 837-9200
Fax
(937) 854-0492
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2012

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

Authorized official

Name
Mr. Michael Proulx
Title
Director of Financial Management
Phone
(937) 837-9258

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Developmentally Disabled Services Day Training Agency 251C00000X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

5450 Salem Ave
Dayton, OH 45426-1450

Mailing address

5450 Salem Ave
Dayton, OH 45426-1450
Phone (937) 837-9200

Other identifiers 3

IdentifierTypeStateIssuer
2741295MedicaidOH
0880337MedicaidOH
2568994MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Montgomery County Board of Developmental Disabilities6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

8114 N Main St
Dayton, OH 45415

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334534400000",
    "number": "1730278441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 SALEM AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454261450",
            "telephone_number": "937-837-9200",
            "fax_number": "937-854-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 SALEM AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454261450",
            "telephone_number": "937-837-9200",
            "fax_number": "937-854-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY COUNTY BOARD OF MR/DD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-04-16",
        "status": "A",
        "authorized_official_last_name": "PROULX",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCIAL MANAGEMENT",
        "authorized_official_telephone_number": "937-837-9258",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2741295",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0880337",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2568994",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2012; 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.