Individual provider Active NPI

Niquole Kelly Egan-Ramirez, ABOC

  • Optician
  • Longmont, CO
National Provider Identifier
1336039163
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
265394 Issued in CO
Practice address
1200 S Hover St
Longmont, CO 80501-7902
Phone
(303) 845-4215
NPI assigned
Jul 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 265394 CO Primary

Addresses

Primary practice location

1200 S Hover St
Longmont, CO 80501-7902

Mailing address

1200 S Hover St
Longmont, CO 80501-7902

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
265394COMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1751500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1336039163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S HOVER ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805017902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S HOVER ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805017902",
            "telephone_number": "303-845-4215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGAN-RAMIREZ",
        "first_name": "NIQUOLE",
        "middle_name": "KELLY",
        "credential": "ABOC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-03",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CO",
            "license": "265394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2025; 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.