SHOPTIKAL LLC (NPI# 1205492675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205492675 |
| Entity Type | Organization |
| Organization Name | SHOPTIKAL LLC |
| Other Organization Name | SHOPKO OPTICAL 4050 |
| Practice Address |
N6663 Rolling Meadows Dr Ste I Fond Du Lac WI 54937-9501 |
| Mailing Address |
Po Box 19060 Green Bay WI 54307-9060 |
| Practice Telephone | 9209218290 |
| Enumeration Date | 2019-05-11 |
| Last Update Date | 2019-12-16 |
| Authorized Official Name | RUSSELL STEINHORST (CEO) |
| Authorized Official Telephone | 9204297489 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| Shopko Optical 4050 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658772 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1073 E Johnson St, Fond Du Lac, WI 54935-8919 | 2020-10-27 |
| 1801493903 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 11995 Business Park Blvd N, Champlin, MN 55316 | 2020-10-02 |
| 1578170247 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 120 N Grand Ave Ste 102, Sun Prairie, WI 53590-9007 | 2020-09-28 |
| 1174138168 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1550 W Lane Rd, Machesney Park, IL 61115-1903 | 2020-09-15 |
| 1639784622 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2268 W Mason St, Green Bay, WI 54303-4707 | 2020-09-15 |
| 1588279566 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1190 S Randall Rd Ste 104, Elgin, IL 60123-4110 | 2020-09-15 |
| 1427669746 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1607 Losey Blvd S, La Crosse, WI 54601-6151 | 2020-08-11 |
| 1710598032 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 631 Hometown Cir Ste 106, Verona, WI 53593-1561 | 2020-08-11 |
| 1457989006 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 3330 E 10th St, Sioux Falls, SD 57103-2107 | 2020-03-30 |
| 1710512801 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 9940 Rt 47, Huntley, IL 60142 | 2020-03-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SHOPTIKAL LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Iowa Business Entities | SHOPTIKAL LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Washington State Corporations | SHOPTIKAL LLC | 700 Pilgrim Way, Green Bay, WI 54304-5263 |
| Street Address |
N6663 ROLLING MEADOWS DR STE I |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54937-9501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710523774 | Lisa Diane Brown | Social Worker | W3950 Wi-23 Trunk, Fond Du Lac, WI 54937 | 2019-11-25 |
| 1538700083 | Kristine Karpen | Technician | 1812 Thurke Ave, North Fond Du Lac, WI 54937 | 2019-10-07 |
| 1962719245 | James Hugh Rupple | Ophthalmology | W4410 Mary Hill Park, Fond Du Lac, WI 54937 | 2010-09-08 |
| 1467591131 | Rosonna Sue Comers | Social Worker | N6687 Wrightway Dr, Ste D, Fond Du Lac, WI 54937 | 2007-02-06 |
| 1487731741 | Daniel James Kierstead | Optometrist | 377 N Rollings Meadows Dr, Fond Du Lac, WI 54937 | 2006-11-01 |
| 1528519758 | Betty Xiong | Physician Assistant | 210 Wisconsin American Dr, Fond Du Lac, WI 54937 | 2016-10-24 |
| 1598112963 | Jennifer M Halbach | Nurse Practitioner | 210 Wisconsin American Dr, Fond Du Lac, WI 54937 | 2016-05-16 |
| 1548667231 | Tanya Watry | Physician Assistant | 210 Wisconsin American Dr, Fond Du Lac, WI 54937 | 2014-11-25 |
| 1578813606 | Joline Brotzman | Nurse Practitioner | 700 Park Ridge Ln, North Fond Du Lac, WI 54937 | 2012-09-17 |
| 1306085998 | Forefront Dermatology, S.c. | Dermatology | 111 Wisconsin American Dr, Fond Du Lac, WI 54937 | 2009-02-05 |
| Find all providers in zip 54937 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658772 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1073 E Johnson St, Fond Du Lac, WI 54935-8919 | 2020-10-27 |
| 1902959273 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 835 W Johnson St Spc C07c, Fond Du Lac, WI 54935 | 2007-01-19 |
| 1558410639 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 757 W Johnson St, Forest Mall, Fond Du Lac, WI 54935-2015 | 2007-01-09 |
| 1154595387 | Agnesian Healthcare Inc | Eyewear Supplier (Equipment, not the service) | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2008-04-18 |
| 1073665527 | Optivision Eye Care LLP | Eyewear Supplier (Equipment, not the service) | 437 N Pioneer Rd, Fond Du Lac, WI 54937 | 2007-01-17 |
| 1841210663 | Aurora Health Care Ventures Inc | Eyewear Supplier (Equipment, not the service) | 210 Wisconsin American Dr, Suite 230, Fond Du Lac, WI 54937-2999 | 2006-07-21 |
| 1013960723 | Shopko Stores Operating Co. LLC | Eyewear Supplier (Equipment, not the service) | 616 W Johnson St, Fond Du Lac, WI 54935-3134 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170247 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 120 N Grand Ave Ste 102, Sun Prairie, WI 53590-9007 | 2020-09-28 |
| 1639784622 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2268 W Mason St, Green Bay, WI 54303-4707 | 2020-09-15 |
| 1427669746 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1607 Losey Blvd S, La Crosse, WI 54601-6151 | 2020-08-11 |
| 1710598032 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 631 Hometown Cir Ste 106, Verona, WI 53593-1561 | 2020-08-11 |
| 1871138073 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 723 Main Ave, Depere, WI 54115 | 2019-11-12 |
| 1558903815 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 422 Gammon Pl, Madison, WI 53719-1026 | 2019-10-08 |
| 1669013256 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 123 N Mall Dr, Grand Chute, WI 54913-8531 | 2019-10-04 |
| 1952962763 | Martell Eyecare, LLC | Eyewear Supplier (Equipment, not the service) | 703 Third Street, Marathon, WI 54448 | 2019-06-23 |
| 1932767316 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1440 Capital Drive, Suite B, Pewaukee, WI 53072 | 2019-05-31 |
| 1942866066 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 9417 State Road 16 Ste 300, Onalaska, WI 54650-8539 | 2019-05-14 |
| Find all providers with the same taxonomy | ||||
| City | FOND DU LAC |
| Zip Code | 54937 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.