Darke County Board of DD

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

DARKE COUNTY BOARD OF DD

Practice address

5844 Jaysville St Johns Rd
Greenville, OH 45331

Phone

(937) 548-9057

Fax

(937) 548-8585

NPI assigned

Jul 26, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Michael R. Beasecker

Title

Superintendent

Phone

(937) 459-4601

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Wayne Industries, Inc. Other name

Locations

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613433600000",
    "number": "1982604682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5844 JAYSVILLE ST JOHNS RD",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "45331",
            "telephone_number": "937-548-9057",
            "fax_number": "937-548-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5844 JAYSVILLE ST JOHNS RD",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "45331",
            "telephone_number": "937-548-9057",
            "fax_number": "937-548-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARKE COUNTY BOARD OF DD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "BEASECKER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "937-459-4601",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "OH",
            "license": "1900018",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2568056",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2556363",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wayne Industries, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Morgan Crutcher, CNP
• Paul G Czernik, LSW
• Eeman Dajani, B.D.S M.S ( DDS)
• Taylor Kae Daniels
• Cynthia M Dapore, RPH
• Darke County General Health District
• Darke County Internal Medicine-Pediatrics, Inc.
• Darke County Mental Health Clinic
• Darke County Mental Health Clinic, Inc
• Darke County Obstetrics and Gynecology

• All providers in Greenville, OH
• Case Management Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.