Active NPI
Sam's Club Optical
Doing business as Sam's Club Optical 30-4982
- Eyewear Supplier
- Mt Pleasant, MI
National Provider Identifier
1891821245
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 30-4982
- Practice address
- 4850 Encore Blvd
Mt. Pleasant, MI 48858 - Phone
- (898) 772-1704
- NPI assigned
- Feb 27, 2007
- 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
- David J. Simmons
- Title
- Npi Associate
- Phone
- (479) 277-9373
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | |||
| Eyewear Supplier | 332H00000X | Primary |
Addresses
Primary practice location
4850 Encore Blvd
Mt. Pleasant, MI 48858
Mailing address
702 SW 8TH St
Bentonville, AR 72716-6209
Phone (479) 277-9373
Other names 1
- Sam's Club Optical 30-4982
National Provider Directory
National Provider Directory- Tax ID family
- Sam's Hearing Aid Center 6332
Organizations with this tax ID in the same state 18
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1891821245",
"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": "727166209",
"telephone_number": "479-277-9373",
"fax_number": "479-277-8176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4850 ENCORE BLVD",
"city": "MT. PLEASANT",
"state": "MI",
"postal_code": "48858",
"telephone_number": "898-772-1704"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAM'S CLUB OPTICAL",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-27",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "SIMMONS",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "J.",
"authorized_official_title_or_position": "NPI ASSOCIATE",
"authorized_official_telephone_number": "479-277-9373"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": null,
"primary": false
},
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Sam's Club Optical 30-4982",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Mt Pleasant, MI
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.