NPIMap

Organization Active NPI

Shopko Stores Operating Co. LLC

  • Eyewear Supplier
  • Omaha, NE
National Provider Identifier
1649222878
Registry record updated Oct 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
SHOPKO STORES OPERATING CO. LLC
Practice address
3044 S 84TH St Ste 1
Omaha, NE 68124-3208
Phone
(402) 391-1143
NPI assigned
May 16, 2006
Last updated
Oct 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Russell Steinhorst
Title
SVP Chief Financial Officer
Phone
(920) 429-7489

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

3044 S 84TH St Ste 1
Omaha, NE 68124-3208

Mailing address

3044 S 84TH St Ste 1
Omaha, NE 68124-3208
Phone (402) 391-1143

Other practice location 1

3020 S 84th St
Omaha, NE 68124-3215
Phone (402) 391-1143

Other identifiers 8

IdentifierTypeStateIssuer
35504OtherAVESIS
17884OtherMEDICARE
260474OtherMEDICARE
41098505418MedicaidNE
007124OtherBLOCK
014044OtherVIP
35860OtherDAVIS
CP2230-31OtherEYEMED

National Provider Directory

National Provider Directory

Locations

3020 S 84th St
Omaha, NE 68124
Phone (402) 391-1143

3044 S 84th St
Ste 1
Omaha, NE 68124
Phone (402) 391-1143

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507593600000",
    "number": "1649222878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3044 S 84TH ST STE 1",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681243208",
            "telephone_number": "402-391-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3044 S 84TH ST STE 1",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681243208",
            "telephone_number": "402-391-1143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3020 S 84th St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681243215",
            "country_code": "US",
            "telephone_number": "402-391-1143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHOPKO STORES OPERATING CO. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2017-10-10",
        "status": "A",
        "authorized_official_last_name": "STEINHORST",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "SVP CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "920-429-7489"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "35504",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "17884",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "260474",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41098505418",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLOCK",
            "identifier": "007124",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIP",
            "identifier": "014044",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS",
            "identifier": "35860",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "CP2230-31",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.