Individual provider Active NPI

Blake Randall Tirman

  • School Registered Nurse
  • Phoenix, AZ
National Provider Identifier
1306754494
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
275550 Issued in AZ
Practice address
4435 E Chandler Blvd
Phoenix, AZ 85048-7649
Phone
(602) 491-1997
NPI assigned
Aug 31, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 275550 AZ Primary

Addresses

Primary practice location

4435 E Chandler Blvd
Phoenix, AZ 85048-7649

Mailing address

4435 E Chandler Blvd
Phoenix, AZ 85048-7649
Phone (602) 491-1997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1306754494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4435 E CHANDLER BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487649",
            "telephone_number": "602-491-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 E CHANDLER BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487649",
            "telephone_number": "602-491-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIRMAN",
        "first_name": "BLAKE",
        "middle_name": "RANDALL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "AZ",
            "license": "275550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.