Active NPI
Jillian Tacia, R.D.
- Registered Dietitian
- Roseville, MI
National Provider Identifier
1497104616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 25710 Kelly Rd
Suite 3
Roseville, MI 48066-4959 - Phone
- (586) 772-2600
- Fax
- (586) 772-5289
- NPI assigned
- Jun 8, 2016
- Sex
- Female
- Sole proprietor
- No
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 Dietitian | 133V00000X | MI | Primary |
Addresses
Primary practice location
25710 Kelly Rd
Suite 3
Roseville, MI 48066-4959
Mailing address
25710 Kelly Rd
Suite 3
Roseville, MI 48066-4959
Phone (586) 772-2600
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490745600000",
"number": "1497104616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25710 KELLY RD",
"address_2": "SUITE 3",
"city": "ROSEVILLE",
"state": "MI",
"postal_code": "480664959",
"telephone_number": "586-772-2600",
"fax_number": "586-772-5289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25710 KELLY RD",
"address_2": "SUITE 3",
"city": "ROSEVILLE",
"state": "MI",
"postal_code": "480664959",
"telephone_number": "586-772-2600",
"fax_number": "586-772-5289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TACIA",
"first_name": "JILLIAN",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-08",
"last_updated": "2017-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.