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SHOPKO OPTICAL 086
NPI 1982656419
Eyewear Supplier in Provo, UT

Active since May 16, 2006
2266 N UNIVERSITY PKWY, PROVO, UT 84604(801) 373-1300 Get Directions Write a Review

NPPES record last updated: July 10, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shopko Optical 086 NPPES

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

SHOPKO OPTICAL 086 (NPI 1982656419) is a healthcare organization registered as an eyewear supplier in Provo, Utah 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

NPI1982656419
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address2266 N UNIVERSITY PKWYProvo, UT 84604-1510
Mailing Address2266 N University PkwyProvo, UT 84604-1510 · (801) 373-1300
Phone(801) 373-1300
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 16, 2006
Last NPPES UpdateJuly 10, 2008
✔ NPI 1982656419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
Also ListedOptometristTaxonomy 152W00000X
Also ListedTechnician/Technologist · OpticianTaxonomy 156FX1800X
2266 N UNIVERSITY PKWY, Provo, UT 84604
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Other Names 1

Doing Business AsShopko Optical 086

Other Identifiers 11

OtherUT04881UT · Noridian Submitter Id
Medicaid410985054-134UT
Other17921Medicare
Other35529Avesis
Medicare PINDF0852
Medicare NSC5695760027UT
OtherCP2230-47Eyemed
Other42548Davis
Medicare ID-Type Unspecified0154160020
Medicare PIN000058212UT
Other014086Vip

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

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)
2266 N UNIVERSITY PKWY
PROVO, UT 84604
Utah County (801) 375-2000

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 1982656419. It was assigned to this organization in the NPPES registry on May 16, 2006. The provider is doing business as Shopko Optical 086.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 2266 N University Pkwy, Provo, UT 84604. The listed phone number is (801) 373-1300.

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 July 10, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.