Individual provider Active NPI

Glenn Ronald Lirman, ARNP

  • Adult Health Nurse Practitioner
  • Kent, WA
National Provider Identifier
1043387830
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP30003222 Issued in WA
Practice address
620 W James St
Kent, WA 98032-4487
Phone
(206) 205-2400
Fax
(206) 205-2439
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP30003222 WA Primary

Addresses

Primary practice location

620 W James St
Kent, WA 98032-4487

Mailing address

4330 Wallingford Ave N
Seattle, WA 98103-7542
Phone (206) 205-2415

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30003222WAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle-King County Dept of Public Health 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043387830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 WALLINGFORD AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981037542",
            "telephone_number": "206-205-2415",
            "fax_number": "206-205-2439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W JAMES ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980324487",
            "telephone_number": "206-205-2400",
            "fax_number": "206-205-2439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIRMAN",
        "first_name": "GLENN",
        "middle_name": "RONALD",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP30003222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.