Individual provider Active NPI

Jill Marie Elian, RN

  • Registered Nurse
  • Grandville, MI
National Provider Identifier
1083409684
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704232591 Issued in MI
Practice address
3101 Prairie St SW
Grandville, MI 49418-2047
Phone
(616) 889-5547
Fax
(616) 889-5547
NPI assigned
Apr 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 4704232591 MI Primary

Addresses

Primary practice location

3101 Prairie St SW
Grandville, MI 49418-2047

Mailing address

6185 Scotthille Dr SE
Ada, MI 49301-7849
Phone (616) 889-5547

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704232591MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1083409684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6185 SCOTTHILLE DR SE",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493017849",
            "telephone_number": "616-889-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 PRAIRIE ST SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182047",
            "telephone_number": "616-889-5547",
            "fax_number": "616-889-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIAN",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704232591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.