Active NPI
Sam's Club Optical
Doing business as Sam's Club Optical 30-8162
- Eyewear Supplier
- Cedar Rapids, IA
National Provider Identifier
1558465989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- SAM'S CLUB OPTICAL
- Doing business as
- Sam's Club Optical 30-8162
- Practice address
- 2605 Blairs Ferry Rd NE
Cedar Rapids, IA 52402-1802 - Phone
- (319) 294-3360
- NPI assigned
- Sep 7, 2006
- Last updated
- Sep 11, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tammy J Boyd
- Title
- Contract Coordinator
- Phone
- (479) 277-1359
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | Primary | ||
| Optician | 156FX1800X |
Addresses
Primary practice location
2605 Blairs Ferry Rd NE
Cedar Rapids, IA 52402-1802
Mailing address
702 SW 8TH St
Bentonville, AR 72716-0235
Other names 1
- Sam's Club Optical 30-8162
National Provider Directory
National Provider Directory- Tax ID family
- Ability Network
Organizations with this tax ID in the same state 11
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Sam's Club Optical 30-6472
- Eyewear Supplier
- Council Bluffs, IA
- NPI 1053415091
-
dba Sam's Club Optical 30-6344
- Eyewear Supplier
- Windsor Heights, IA
- NPI 1649360835
Locations
2605 Blairs Ferry Rd NE
Cedar Rapids, IA 52402
Phone (319) 294-3360
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1558465989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 SW 8TH ST",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727160235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2605 BLAIRS FERRY RD NE",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524021802",
"telephone_number": "319-294-3360"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAM'S CLUB OPTICAL",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-07",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "BOYD",
"authorized_official_first_name": "TAMMY",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "CONTRACT COORDINATOR",
"authorized_official_telephone_number": "479-277-1359"
},
"taxonomies": [
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": null,
"license": null,
"primary": true
},
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Sam's Club Optical 30-8162",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Cedar Rapids, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.