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SHOPKO OPTICAL 028
NPI 1932152501
Eyewear Supplier in Kimberly, WI

Active since May 18, 2006
800 E MAES AVE, KIMBERLY, WI 54136(920) 788-4114 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 028 NPPES

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

SHOPKO OPTICAL 028 (NPI 1932152501) is a healthcare organization registered as an eyewear supplier in Kimberly, 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

NPI1932152501
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address800 E MAES AVEKimberly, WI 54136-1527
Mailing Address800 E Maes AveKimberly, WI 54136-1527 · (920) 788-4114
Phone(920) 788-4114
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 18, 2006
Last NPPES UpdateFebruary 11, 2008
✔ NPI 1932152501 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.
800 E MAES AVE, Kimberly, WI 54136
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Other Names 1

Doing Business AsShopko Optical 028

Other Identifiers 10

Other42621Davis
OtherCP2230-74Eyemed
Medicare ID-Type Unspecified0154160055
Other014028Vip
Other35569Avesis
Other410985054-4028Nva
Medicare PINDF0804
Other17646Medicare
Medicare NSC5695760108WI
Medicaid38409100WI

Other Providers at the Same Location NPPES 8

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)
800 E MAES AVE
KIMBERLY, WI 54136
Outagamie County (920) 788-9154
DR. DANIEL WAYNE STEFFEN RPH
Pharmacist
800 E MAES AVE
KIMBERLY, WI 54136
Outagamie County (920) 788-9154
THOMAS E KRAUS RPH
Pharmacist
800 E MAES AVE
KIMBERLY, WI 54136
Outagamie County (920) 788-9154
TODD DOXTATER R.PH
Pharmacist
800 E MAES AVE
KIMBERLY, WI 54136
Outagamie County (920) 788-9154
DR. DAVID PAUL SMITS O.D.
Optometrist
800 E MAES AVE
KIMBERLY, WI 54136
Outagamie County (920) 788-4114
MR. EMORY WAYNE LAFFIN RPH
Pharmacist
800 E MAES AVE
KIMBERLY, WI 54136
Outagamie County (920) 788-9154
KAY PULLEN PHARM. D.
Pharmacist
800 E MAES AVE
KIMBERLY, WI 54136
Outagamie County (920) 788-9156
MRS. BETH MARIE BENNIN PHARMD
Pharmacist
800 E MAES AVE
KIMBERLY, WI 54136
Outagamie County (920) 788-9154

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 1932152501. It was assigned to this organization in the NPPES registry on May 18, 2006. The provider is doing business as Shopko Optical 028.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 800 E Maes Ave, Kimberly, WI 54136. The listed phone number is (920) 788-4114.

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.