Individual provider Active NPI

Shaneeka Nicole Dedrick, LPN

  • Licensed Practical Nurse
  • Akron, OH
National Provider Identifier
1538043674
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
172148 Issued in OH
Practice address
359 Wayne Ave
Akron, OH 44301-3101
Phone
(330) 573-4827
NPI assigned
Aug 1, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164W00000X 172148 OH Primary

Addresses

Primary practice location

359 Wayne Ave
Akron, OH 44301-3101

Mailing address

359 Wayne Ave
Akron, OH 44301-3101
Phone (330) 573-4827

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
172148OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1754006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1538043674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 WAYNE AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443013101",
            "telephone_number": "330-573-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 WAYNE AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443013101",
            "telephone_number": "330-573-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDRICK",
        "first_name": "SHANEEKA",
        "middle_name": "NICOLE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-01",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "172148",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 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.

Verify at the official NPI Registry.