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SHOPKO OPTICAL 171
NPI 1578516936
Eyewear Supplier in Plover, WI

Active since May 18, 2006
1800 PLOVER RD, PLOVER, WI 54467(715) 342-9634 Get Directions Write a Review

NPPES record last updated: February 11, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shopko Optical 171 NPPES

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

SHOPKO OPTICAL 171 (NPI 1578516936) is a healthcare organization registered as an eyewear supplier in Plover, 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

NPI1578516936
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address1800 PLOVER RDPlover, WI 54467-3978
Mailing Address1800 Plover RdPlover, WI 54467-3978 · (715) 342-9634
Phone(715) 342-9634
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 18, 2006
Last NPPES UpdateFebruary 11, 2008
✔ NPI 1578516936 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.
1800 PLOVER RD, Plover, WI 54467
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Other Names 1

Doing Business AsShopko Optical 171

Other Identifiers 10

Other47565Medicare
Medicare PINDF0804
Other35583Avesis
Medicare ID-Type Unspecified0154160072
Other014171Vip
OtherCP2230-86Eyemed
Medicare NSC5695760016WI
Other17666Medicare
Other42570Davis
Medicaid38716300WI

Other Providers at the Same Location NPPES 5

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

SHOPKO STORES OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
1800 PLOVER RD
PLOVER, WI 54467
Portage County (715) 342-9368
DANIEL REBHOLZ
Pharmacist
1800 PLOVER RD
PLOVER, WI 54467
Portage County (715) 342-9368
MRS. KIMBERLEY LOUISE LAUBE PHARMD
Pharmacist
1800 PLOVER RD
PLOVER, WI 54467
Portage County (715) 342-9368
MR. JOHN GERARD JANSEN R.PH.
Pharmacist
1800 PLOVER RD
PLOVER, WI 54467
Portage County (715) 342-9613
DR. MARC FREDERIKSEN O.D.
Optometrist
1800 PLOVER RD
PLOVER, WI 54467
Portage County (715) 342-9634

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 1578516936. It was assigned to this organization in the NPPES registry on May 18, 2006. The provider is doing business as Shopko Optical 171.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 1800 Plover Rd, Plover, WI 54467. The listed phone number is (715) 342-9634.

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.