Healthcare Provider Details

I. General information

NPI: 1417801077
Provider Name (Legal Business Name): CASEY JAMES RUPPEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1871 FENTON AVE
AKRON OH
44312-1015
US

IV. Provider business mailing address

1871 FENTON AVE
AKRON OH
44312-1015
US

V. Phone/Fax

Practice location:
  • Phone: 330-617-6445
  • Fax:
Mailing address:
  • Phone: 330-617-6445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: