Individual provider Active NPI

Lucille W Glenn, MD

  • Diagnostic Radiology Physician
  • Seattle, WA
National Provider Identifier
1750301214
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD00023849 Issued in WA
Practice address
1100 9TH Ave
Seattle, WA 98101-2756
Phone
(206) 223-6600
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD00023849 WA Primary

Addresses

Primary practice location

1100 9TH Ave
Seattle, WA 98101-2756

Mailing address

1100 9TH Ave
Ms M4-PA
Seattle, WA 98101-2756
Phone (206) 583-6025

Other identifiers 7

IdentifierTypeStateIssuer
806277300OtherWAINDAHO MEDICAID
300042305OtherWARAILROAD MEDICARE
0038587OtherWALABOR & INDUSTRY
8117467MedicaidWA
MD430WAOtherWAALASKA MEDICAID
GL5250OtherWABLUE SHIELD
US0863569OtherWAAETNA/USHC SPECIALIST

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00023849WAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center- Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients

Locations

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

1100 9th Ave
#M4
Seattle, WA 98101
Phone (206) 515-5811

Interoperability endpoints

  • Direct secure messaging: lucy.glenn@direct.vmmc.org

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1750301214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "address_2": "MS M4-PA",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-583-6025",
            "fax_number": "206-515-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-223-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "LUCILLE",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00023849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDAHO MEDICAID",
            "identifier": "806277300",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300042305",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "0038587",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8117467",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALASKA MEDICAID",
            "identifier": "MD430WA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "GL5250",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/USHC SPECIALIST",
            "identifier": "US0863569",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.