Active NPI
Tanya G. Nicholson, O.D.
- Optometrist
- Ft Collins, CO
National Provider Identifier
1003877937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2094
- Practice address
- 1250 E Magnolia St
Located in Wal-Mart
Ft Collins, CO 80524-2754 - Phone
- (970) 224-0606
- Fax
- (970) 493-9309
- NPI assigned
- Mar 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2094 | CO | Primary |
Addresses
Primary practice location
1250 E Magnolia St
Located in Wal-Mart
Ft Collins, CO 80524-2754
Mailing address
396 N Snowmass Cir
Superior, CO 80027-6124
Phone (303) 818-1852
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2094 | CO | MD | Forensic Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1003877937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "396 N SNOWMASS CIR",
"city": "SUPERIOR",
"state": "CO",
"postal_code": "800276124",
"telephone_number": "303-818-1852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 E MAGNOLIA ST",
"address_2": "LOCATED IN WAL-MART",
"city": "FT COLLINS",
"state": "CO",
"postal_code": "805242754",
"telephone_number": "970-224-0606",
"fax_number": "970-493-9309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "TANYA",
"middle_name": "G.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-30",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "2094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.