Individual provider Active NPI

Bruce D Lirones, DO

  • Family Medicine Physician
  • Rapid City, MI
National Provider Identifier
1881786762
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101008200 Issued in MI
Practice address
9895 Rapid City Rd NW
Rapid City, MI 49676-9506
Phone
(231) 331-4283
Fax
(231) 331-6115
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101008200 MI Primary

Addresses

Primary practice location

9895 Rapid City Rd NW
Rapid City, MI 49676-9506

Mailing address

9895 Rapid City Rd NW
Rapid City, MI 49676-9506
Phone (231) 331-4283

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
5101008200MIMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260835200000",
    "number": "1881786762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9895 RAPID CITY RD NW",
            "city": "RAPID CITY",
            "state": "MI",
            "postal_code": "496769506",
            "telephone_number": "231-331-4283",
            "fax_number": "231-331-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9895 RAPID CITY RD NW",
            "city": "RAPID CITY",
            "state": "MI",
            "postal_code": "496769506",
            "telephone_number": "231-331-4283",
            "fax_number": "231-331-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIRONES",
        "first_name": "BRUCE",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2009-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101008200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; 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.