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SHOPKO OPTICAL 051
NPI 1053363010
Eyewear Supplier in Fort Atkinson, WI

Active since May 17, 2006
1425 JANESVILLE AVE, FORT ATKINSON, WI 53538(920) 563-2171 Get Directions Write a Review

NPPES record last updated: February 11, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shopko Optical 051 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHOPKO OPTICAL 051 (NPI 1053363010) is a healthcare organization registered as an eyewear supplier in Fort Atkinson, Wisconsin and active in the NPI registry since May 2006. The organization lists Michael J Bettiga, Sr. Vice President Health Services, as its authorized official.

NPPES Registry Identity

NPI1053363010
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address1425 JANESVILLE AVEFort Atkinson, WI 53538-2705
Mailing Address1425 Janesville AveFort Atkinson, WI 53538-2705 · (920) 563-2171
Phone(920) 563-2171
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateFebruary 11, 2008
✔ NPI 1053363010 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
1425 JANESVILLE AVE, Fort Atkinson, WI 53538
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Other Names 1

Doing Business AsShopko Optical 051

Other Identifiers 10

Other35561Avesis
OtherCP2230-67Eyemed
Other42598Davis
Medicaid38450700WI
Medicare PINDF0804
Other17655Medicare
Other410985054-4051Nva
Other014051Vip
Medicare ID-Type Unspecified0154160106
Medicare NSC5695760067WI

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ADELAIDE HARGARTEN
Pharmacist
1425 JANESVILLE AVE
FORT ATKINSON, WI 53538
Jefferson County (920) 563-9351
SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
1425 JANESVILLE AVE
FORT ATKINSON, WI 53538
Jefferson County (920) 563-9351
MRS. AMY BETH REITHMEYER
Pharmacist
1425 JANESVILLE AVE
FORT ATKINSON, WI 53538
Jefferson County (920) 563-9351
MRS. CHELSEA ANN LINZMEIER O.D.
Optometrist
1425 JANESVILLE AVE
FORT ATKINSON, WI 53538
Jefferson County (920) 563-2171

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shopko Stores Operating Co. LLC's NPI number?

The NPI number for Shopko Stores Operating Co. LLC is 1053363010. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 051.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 1425 Janesville Ave, Fort Atkinson, WI 53538. The listed phone number is (920) 563-2171.

What is Shopko Stores Operating Co. LLC's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

When was this NPI record last updated?

The NPPES record for Shopko Stores Operating Co. LLC was last updated on February 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.