Active NPI
Elizabeth Rae Merrill, RDN
- Registered Dietitian
- Grand Haven, MI
National Provider Identifier
1508338179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86085592
- Practice address
- 15054 Lukas CT Apt 320
Grand Haven, MI 49417-7992 - Phone
- (616) 990-7208
- NPI assigned
- Dec 20, 2018
- 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 | 86085592 | MI | Primary |
Addresses
Primary practice location
15054 Lukas CT Apt 320
Grand Haven, MI 49417-7992
Mailing address
15054 Lukas CT Apt 320
Grand Haven, MI 49417-7992
Phone (616) 990-7208
Other names 1
- Mrs. Elle Rae Merrill
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86085592 | MI | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545264000000",
"number": "1508338179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15054 LUKAS CT APT 320",
"city": "GRAND HAVEN",
"state": "MI",
"postal_code": "494177992",
"telephone_number": "616-990-7208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15054 LUKAS CT APT 320",
"city": "GRAND HAVEN",
"state": "MI",
"postal_code": "494177992",
"telephone_number": "616-990-7208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRILL",
"first_name": "ELIZABETH",
"middle_name": "RAE",
"name_prefix": "Mrs.",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-20",
"last_updated": "2018-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MI",
"license": "86085592",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELLE",
"last_name": "MERRILL",
"middle_name": "RAE",
"prefix": "MRS.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Grand Haven, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.