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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

SAMANTHA ELLIS
NPI 1043124456
Registered Nurse in Grand Rapids, MI

Active since October 01, 2026
1104 MAYBELLE ST NE, GRAND RAPIDS, MI 49503(269) 275-4903 Get Directions Write a Review

NPPES record added: October 1, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Samantha Ellis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA ELLIS (NPI 1043124456) is an individual registered nurse in Grand Rapids, Michigan, licensed in Michigan (4704367347) and active in the NPI registry since October 2026.

NPPES Registry Identity

NPI1043124456
Entity TypeIndividual
Primary Taxonomy163W00000X
Provider Legal NameSAMANTHA ELLIS
Location Address1104 MAYBELLE ST NEGrand Rapids, MI 49503-1240
Mailing Address1104 Maybelle St NeGrand Rapids, MI 49503-1240
Phone(269) 275-4903
Sole ProprietorNo
Enumeration DateOctober 1, 2026
NPPES CertifiedOctober 1, 2026
✔ NPI 1043124456 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered NurseNursing Service Providers
Taxonomy Code163W00000X
License✔ Licensed in MI · 4704367347
Definition
(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.
1104 MAYBELLE ST NE, Grand Rapids, MI 49503
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samantha Ellis's NPI number?

The NPI number for Samantha Ellis is 1043124456. It was assigned to this individual provider in the NPPES registry on October 1, 2026.

Where is Samantha Ellis located?

Samantha Ellis practices at 1104 Maybelle St NE, Grand Rapids, MI 49503. The listed phone number is (269) 275-4903.

What is Samantha Ellis's specialty?

The primary specialty registered for this NPI is Registered Nurse with taxonomy code 163W00000X.

When was this NPI record last updated?

The NPPES record for Samantha Ellis was last updated on October 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.