ShopKo Optical 084 – Eyewear Supplier, NPI 1679525109

ShopKo Optical 084 is a healthcare provider. based in West jordan, Utah. specializing in Eyewear Supplier. The NPI Number for ShopKo Optical 084 is 1679525109

Main info

Organization
Name
ShopKo Optical 084
NPI
1679525109
Phone
(801) 561-7300
Address
1553 W 9000 S
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 084

  • Sportsman's Warehouse Corporate Office, 1475 W, 9000 South, West Jordan, Salt Lake County, Utah, 84088, United States

    WEST JORDAN, UT 840889219

    Phone: (801) 561-7300

    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 84088)

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Reviews

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Frequently asked questions

Can I use this page to confirm ShopKo Optical 084's NPI?
Yes. ShopKo Optical 084 is listed with NPI 1679525109 in the public NPI dataset.
Does CMS list ShopKo Optical 084 as active?
Yes — ShopKo Optical 084 is active in the NPI listing used on this page.
What taxonomy line describes ShopKo Optical 084?
For research purposes, treat ShopKo Optical 084 as Eyewear Supplier in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect ShopKo Optical 084 on a map?
Expect West Jordan, Utah as a primary anchor for ShopKo Optical 084 unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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