Individual provider Active NPI

Jill Hannah, NP

  • Nurse Practitioner
  • Ypsilanti, MI
National Provider Identifier
1760422646
Registry record updated Aug 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71002065A Issued in IN
Practice address
5333 McAuley Dr
Suite 6016
Ypsilanti, MI 48197-1014
Phone
(734) 712-8350
Fax
(734) 712-8351
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71002065A IN Primary

Addresses

Primary practice location

5333 McAuley Dr
Suite 6016
Ypsilanti, MI 48197-1014

Mailing address

5333 McAuley Dr
Suite 6016
Ypsilanti, MI 48197-1014
Phone (734) 712-8350

Other identifiers 1

IdentifierTypeStateIssuer
200833790AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140127001524 MI Practitioner - Nurse Practitioner 5496757379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huron Valley Radiology PCGroup PAC ID 2961466859, 76 clinicians

Practice addresses (Care Compare)

5333 McAuley Dr
RM 6016
Ypsilanti, MI 48197-1005
Phone (734) 712-8350

Hospital & facility affiliations

  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
  • Chelsea Hospital Hospital, Chelsea, MI, CCN 230259
  • Trinity Health Livingston Hospital Hospital, Howell, MI, CCN 230069
  • St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71002065AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
X-Ray Consultants Inc CurrentSince Apr 1, 2024 Accepting new patients
Huron Valley Radiology PC CurrentSince Dec 1, 2013 Accepting new patients
Mercy Medical Partners Northern Region LLC Past Accepting new patients
Indiana University Radiology Associates, Inc. Past Accepting new patients

Locations

7575 Grand River Rd
Ste 103
Brighton, MI 48114
Phone (866) 522-8268

5303 Elliott Dr
#2661
Ypsilanti, MI 48197
Phone (734) 712-0280

5333 McAuley Dr
Rm 6016
Ypsilanti, MI 48197

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377820800000",
    "number": "1760422646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR",
            "address_2": "SUITE 6016",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971014",
            "telephone_number": "734-712-8350",
            "fax_number": "734-712-8351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR",
            "address_2": "SUITE 6016",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971014",
            "telephone_number": "734-712-8350",
            "fax_number": "734-712-8351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAH",
        "first_name": "JILL",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2013-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71002065A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200833790A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.