MEDICARE: THOMAS J INGERSOLL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist	APS.007228	OH

General Provider Information

NPI Number	:	1124985650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS J INGERSOLL

Provider Business Mailing Address
First Line	:	2438 THURMONT RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44313-5444
Country	:	US
Telephone Number	:	305-610-2502
Fax Number	:

Provider Business Practice Location Address
First Line	:	2438 THURMONT RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44313-5444
Country	:	US
Telephone Number	:	305-610-2502
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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Directions to “ THOMAS J INGERSOLL ” Practice Location

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