Healthcare Provider Details

I. General information

NPI: 1558229989
Provider Name (Legal Business Name): SCOTT STEVEN CARPENTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2026
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W BOWERY ST
AKRON OH
44308-1069
US

IV. Provider business mailing address

2132 STONEHENGE CIR
AKRON OH
44319-5506
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-5311
  • Fax:
Mailing address:
  • Phone: 330-815-7578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT.001690
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: