Longmont Eyecare, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0003344 Issued in CO

Legal business name

LONGMONT EYECARE, PLLC

Practice address

2285 E Ken Pratt Blvd
Longmont, CO 80504-5223

Phone

(720) 652-0455

NPI assigned

Sep 1, 2017

Organization subpart

No

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

Authorized official

Name

Grace Kim, ODNPI 1760648497

Title

Optometrist/Ceo

Phone

(720) 652-0455

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Grace J Kim, OD

  • Optometrist
  • Longmont, CO
  • NPI 1760648497
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594857600000",
    "number": "1104344894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 E KEN PRATT BLVD",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805045223",
            "telephone_number": "720-652-0455",
            "fax_number": "303-532-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2285 E KEN PRATT BLVD",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805045223",
            "telephone_number": "720-652-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGMONT EYECARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-01",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "OPTOMETRIST/CEO",
        "authorized_official_telephone_number": "720-652-0455",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "0003344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Longmont Clinic Lab
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• Longmont Dental Partners, LLC.
• Longmont Family Dental, PLLC
• Longmont Family Eye Doctors PLLC
• Longmont Foot and Ankle Clinic, P.C.
• Longmont Hospitalist Group, LLC
• Longmont Integrative Family Practice PLLC

• Optometrist in Longmont, CO
• Providers in Longmont, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.