SHOPKO OPTICAL 4017
NPI 1174575500
Eyewear Supplier in Saint Cloud, MN
NPI Status: Active since May 16, 2006
Contact Information
4161 2ND ST S
SAINT CLOUD, MN
ZIP 56301
Phone: (320) 253-5994
- Organization
- Eyewear Supplier
About SHOPKO OPTICAL 4017
This page provides the complete NPI Profile along with additional information for Shopko Optical 4017, a provider established in Saint Cloud, Minnesota operating as a Eyewear Supplier. The healthcare provider is registered in the NPI registry with number 1174575500 assigned on May 2006. The practitioner's primary taxonomy code is 332H00000X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's is doing business as Shopko Optical 4017. The authorized official of this NPI record is Michael J Bettiga Rph (Sr. Vice President Health Services)
- NPI
- 1174575500
- Provider Legal Name
- SHOPKO STORES OPERATING CO. LLC
- Other Organization Name
- SHOPKO OPTICAL 4017
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 4161 2ND ST S SAINT CLOUD, MN 56301
- Location Phone
- (320) 253-5994
- Mailing Address
- 4161 2ND ST S SAINT CLOUD, MN 56301
- Mailing Phone
- (320) 253-5994
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-16-2006
- Last Update Date
- 04-15-2008
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Eyewear Supplier
- Taxonomy Code
- 332H00000X
- Type
- Suppliers
- Taxonomy Description
- An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 23667 | OTHER (01) | MN HEALTH PARTNERS | |
| 35585 | OTHER (01) | AVESIS | |
| CP2230-22 | OTHER (01) | EYEMED | |
| 2123169 | OTHER (01) | MN MA MEDICA CHOICE CARE | |
| 0154160098 | MEDICARE ID-TYPE UNSPECIFIED (04) | ||
| DF0849 | MEDICARE PIN (08) | ||
| 77166SH | OTHER (01) | MN MA FIRST PLAN OF MN | |
| C04276 | MEDICARE PIN (08) | ||
| 014017 | OTHER (01) | VIP | |
| 77168MA | OTHER (01) | MN BLUE PLUS CARE | |
| 410985054-4017 | OTHER (01) | NATIONAL VISION ADMIN. | |
| 5695760020 | MEDICARE NSC (07) | MN | |
| 35479 | OTHER (01) | AVESIS | |
| 42601 | OTHER (01) | DAVIS | |
| 03092036202 | OTHER (01) | MN MA PRIMEWEST HEALTH | |
| 17821 | OTHER (01) | MEDICARE |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1174575500, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 50 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
SAINT CLOUD, MN 56301
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174575500, enumerated as an "organization" on May 16, 2006.
The provider is located at 4161 2ND ST S SAINT CLOUD, MN 56301 and the phone number is (320) 253-5994.
Eyewear Supplier with taxonomy code 332H00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
