Active NPI
Sam's Club Optical
Doing business as Sam's Club Optical 30-6667
- Eyewear Supplier
- Ypsilanti, MI
National Provider Identifier
1922190495
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 30-6667
- Practice address
- 5450 Carpenter Rd
Ypsilanti, MI 48197-9019 - Phone
- (734) 434-1326
- NPI assigned
- Sep 29, 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
- Linda M. Epperson
- Title
- Npi Coordinator
- Phone
- (316) 788-5580
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | NU | ||
| Eyewear Supplier | 332H00000X | NU | Primary |
Addresses
Primary practice location
5450 Carpenter Rd
Ypsilanti, MI 48197-9019
Mailing address
702 SW 8TH Street
Bentonville, AR 72716-0235
Other names 1
- Sam's Club Optical 30-6667
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2099785 | Sam's Club #6667 | Certificate of waiver | Aug 2, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Sam's Hearing Aid Center 6332
Organizations with this tax ID in the same state 15
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": "1159488000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1922190495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 SW 8TH STREET",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727160235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5450 CARPENTER RD",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481979019",
"telephone_number": "734-434-1326"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAM'S CLUB OPTICAL",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-29",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "EPPERSON",
"authorized_official_first_name": "LINDA",
"authorized_official_middle_name": "M.",
"authorized_official_title_or_position": "NPI COORDINATOR",
"authorized_official_telephone_number": "316-788-5580"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Sam's Club Optical 30-6667",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Ypsilanti, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.