Active NPI
Adam Wackerly
- Registered Respiratory Therapist
- Malvern, OH
National Provider Identifier
1457230641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Respiratory Therapist
- License
- RCP.15522
- Practice address
- 155 Cheyenne TRL
Malvern, OH 44644-9525 - Phone
- (330) 771-7515
- Fax
- (330) 771-7515
- NPI assigned
- Sep 1, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Respiratory Therapist | 227900000X | RCP.15522 | OH | Primary |
Addresses
Primary practice location
155 Cheyenne TRL
Malvern, OH 44644-9525
Mailing address
155 Cheyenne TRL
Malvern, OH 44644-9525
Phone (330) 771-7515
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RCP.15522 | OH | MD | Registered Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756684800000",
"number": "1457230641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 CHEYENNE TRL",
"city": "MALVERN",
"state": "OH",
"postal_code": "446449525",
"telephone_number": "330-771-7515",
"fax_number": "330-771-7515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 CHEYENNE TRL",
"city": "MALVERN",
"state": "OH",
"postal_code": "446449525",
"telephone_number": "330-771-7515",
"fax_number": "330-771-7515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WACKERLY",
"first_name": "ADAM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-09-01",
"last_updated": "2025-09-01",
"certification_date": "2025-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "227900000X",
"taxonomy_group": "",
"desc": "Respiratory Therapist, Registered",
"state": "OH",
"license": "RCP.15522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malvern, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.