Individual provider Active NPI

Justin Lill, BSRT, R.T.(R)(ARRT)

  • Radiologic Technologist
  • Grand Forks, ND
National Provider Identifier
1043137862
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiologic TechnologistTaxonomy code 247100000X
License
1057 Issued in ND
Practice address
1407 24TH Ave S Ste 100
Grand Forks, ND 58201-6761
Phone
(701) 335-4380
NPI assigned
Jul 2, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic Technologist 247100000X 1057 ND Primary

Addresses

Primary practice location

1407 24TH Ave S Ste 100
Grand Forks, ND 58201-6761

Mailing address

4896 Chestnut St
Grand Forks, ND 58201-8014
Phone (701) 213-0463

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

NPI Registry JSON

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

{
    "created_epoch": "1782950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1043137862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4896 CHESTNUT ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582018014",
            "telephone_number": "701-213-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 24TH AVE S STE 100",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016761",
            "telephone_number": "701-335-4380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILL",
        "first_name": "JUSTIN",
        "credential": "BSRT, R.T.(R)(ARRT)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-02",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "ND",
            "license": "1057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; 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.