Individual provider Active NPI

Nicole Marie Grimes, OD

  • Optometrist
  • Lakewood, CO
National Provider Identifier
1164093381
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0003689 Issued in CO
Practice address
7111 W Alameda Ave Unit L
Lakewood, CO 80226-3300
Phone
(303) 934-0268
NPI assigned
Jul 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0003689 CO Primary

Addresses

Primary practice location

7111 W Alameda Ave Unit L
Lakewood, CO 80226-3300

Mailing address

7511 S 28TH Ter
Phoenix, AZ 85042-6047
Phone (480) 327-8704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230615003168 CO Practitioner - Optometry 7618335084 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
One Hour Optical Medical Services, PCGroup PAC ID 4880662485, 42 clinicians

Practice addresses (Care Compare)

15209 E 103Rd PL
Unit 1200
Commerce City, CO 80022-0746
Phone (720) 499-8349

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0003689COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
North Range Eye Care PC Optometrist CurrentSince Aug 1, 2023 Accepting new patients
One Hour Optical Medical Services, PC Optometrist CurrentSince Sep 14, 2024 Accepting new patients
One Hour Optical Medical Services, PC Optometrist CurrentSince Sep 14, 2024 Accepting new patients
Wirebird Vision, LCC Optometrist PastSince Jul 17, 2021 Accepting new patients
North Range Eye Care, P.C. Optometrist Past Accepting new patients
A & E Vision, Inc. PastSince Jul 17, 2021 Accepting new patients

Locations

13599 E 104th Ave
Unit 400
Commerce City, CO 80022
Phone (720) 499-8349

15209 E 103rd Pl
Unit 1200
Commerce City, CO 80022
Phone (720) 499-8349

1685 S Colorado Blvd
Unit O
Denver, CO 80222
Phone (303) 757-6747

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1164093381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7511 S 28TH TER",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426047",
            "telephone_number": "480-327-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7111 W ALAMEDA AVE UNIT L",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802263300",
            "telephone_number": "303-934-0268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "0003689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.