Individual provider Active NPI

Jwaun R Redick

  • Nurse's Aide
  • Akron, OH
National Provider Identifier
1003325812
Registry record updated Sep 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
400123640602 Issued in OH
Practice address
1000 Biruta St
Akron, OH 44307-1014
Phone
(330) 573-9302
NPI assigned
Sep 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 400123640602 OH Primary

Addresses

Primary practice location

1000 Biruta St
Akron, OH 44307-1014

Mailing address

1000 Biruta St
Akron, OH 44307-1014
Phone (330) 573-7923

Other identifiers 1

IdentifierTypeStateIssuer
0224338MedicaidOH

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

LicenseStateTypeSpecialty
400123640602OHMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1506297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506297600000",
    "number": "1003325812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BIRUTA ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443071014",
            "telephone_number": "330-573-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BIRUTA ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443071014",
            "telephone_number": "330-573-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDICK",
        "first_name": "JWAUN",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-25",
        "last_updated": "2017-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "400123640602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0224338",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2017; 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.