SHOPKO OPTICAL 012
NPI 1265484265
Eyewear Supplier in Wisconsin Rapids, WI

Active since May 17, 2006
1100 E RIVERVIEW EXPY, WISCONSIN RAPIDS, WI 54494(715) 423-1340 Get Directions Write a Review

NPPES record last updated: February 11, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Optical 012 NPPES

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

SHOPKO OPTICAL 012 (NPI 1265484265) is a healthcare organization registered as an eyewear supplier in Wisconsin Rapids, 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

NPI1265484265
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address1100 E RIVERVIEW EXPYWisconsin Rapids, WI 54494-5483
Mailing Address1100 E Riverview ExpyWisconsin Rapids, WI 54494-5483 · (715) 423-1340
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateFebruary 11, 2008
NPI 1265484265 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.
1100 E RIVERVIEW EXPY, Wisconsin Rapids, WI 54494

Other Names 1

Doing Business AsShopko Optical 012

Other Identifiers 11

Other42587Davis
Other410985054-4012Nva
Medicare ID-Type Unspecified0154160095
Other35595Avesis
Medicaid38409000WI
Medicare NSC5695760005WI
Medicare PINDF0804
OtherCP2230-93Eyemed
Other014012Vip
Other13864Medicare
Other87832Medicare

Other Providers at the Same Location NPPES 7

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

Optometrist
1100 E RIVERVIEW EXPY
WISCONSIN RAPIDS, WI 54494
Pharmacist
1100 E RIVERVIEW EXPY
WISCONSIN RAPIDS, WI 54494
Pharmacist
1100 E RIVERVIEW EXPY
WISCONSIN RAPIDS, WI 54494
Pharmacy (Community/Retail Pharmacy)
1100 E RIVERVIEW EXPY
WISCONSIN RAPIDS, WI 54494
Pharmacist
1100 E RIVERVIEW EXPY
WISCONSIN RAPIDS, WI 54494
Pharmacist
1100 E RIVERVIEW EXPY
WISCONSIN RAPIDS, WI 54494
Optometrist
1100 E RIVERVIEW EXPY
WISCONSIN RAPIDS, WI 54494

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 1265484265. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 012.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 1100 E Riverview Expy, Wisconsin Rapids, WI 54494. The listed phone number is (715) 423-1340.

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 with the weekly NPPES data releases published by CMS.