ShopKo Optical 091 – Eyewear Supplier, NPI 1609828136

ShopKo Optical 091 is a healthcare provider. based in Logan, Utah. specializing in Eyewear Supplier. The NPI Number for ShopKo Optical 091 is 1609828136

Main info

Organization
Name
ShopKo Optical 091
NPI
1609828136
Phone
(435) 753-0700
Address
1341 N MAIN ST
Authorized Official
MICHAEL J BETTIGA SR. VICE PRESIDENT HEALTH SERVICES RPH
Enumeration Date
16 May 2006
Last Update Date
10 July 2008
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness80
Years active:20State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for ShopKo Optical 091

  • North Main Street, Lincoln, Logan County, Illinois, 62656, United States

    LOGAN, UT 843412221

    Phone: (435) 753-0700

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84341)

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Reviews

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Frequently asked questions

What is the standard ID for ShopKo Optical 091 in the U.S.?
In the U.S., ShopKo Optical 091 is identified by NPI 1609828136.
Does the public listing show ShopKo Optical 091 as active?
ShopKo Optical 091's NPI record reflects an active status in NPPES.
What does the directory say ShopKo Optical 091 does?
Insurance directories may phrase it differently, but here ShopKo Optical 091 maps to Eyewear Supplier. Clinical services aligned with this taxonomy classification.
Is ShopKo Optical 091 tied to Logan, Utah?
If you are local to Logan, Utah, ShopKo Optical 091 may be relevant to your search.
Can I export ShopKo Optical 091's record?
You can download the official NPPES record; we summarize key fields for readability.

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