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SHOPKO OPTICAL 116
NPI 1831141746
Eyewear Supplier in Sheboygan, WI

Active since May 17, 2006
518 S TAYLOR DR, SHEBOYGAN, WI 53081(920) 458-5757 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 116 NPPES

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

SHOPKO OPTICAL 116 (NPI 1831141746) is a healthcare organization registered as an eyewear supplier in Sheboygan, 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

NPI1831141746
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address518 S TAYLOR DRSheboygan, WI 53081-4253
Mailing Address518 S Taylor DrSheboygan, WI 53081-4253 · (920) 458-5757
Phone(920) 458-5757
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 17, 2006
Last NPPES UpdateFebruary 11, 2008
✔ NPI 1831141746 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.
518 S TAYLOR DR, Sheboygan, WI 53081
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Other Names 1

Doing Business AsShopko Optical 116

Other Identifiers 9

Medicaid38710200WI
Other42524Davis
Other014116Vip
Medicare ID-Type Unspecified0154160233
Medicare NSC5695760014WI
OtherCP230-90Eyemed
Medicare PINDF0804
Other410985054-4116Nva
Other17660Medicare

Other Providers at the Same Location NPPES 3

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)
518 S TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 458-0040
KRISTI DUBAN PHARMD
Pharmacist
518 S TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 458-0040
DR. SHANNON MACNAB O.D.
Optometrist
518 S TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 458-5757

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 1831141746. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 116.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 518 S Taylor Dr, Sheboygan, WI 53081. The listed phone number is (920) 458-5757.

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.