SHOPKO STORES OPERATING COMPANY (NPI# 1962452052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962452052 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING COMPANY |
| Practice Address |
2430 E Mason St Green Bay WI 54302-3759 |
| Practice Telephone | 9204684642 |
| Practice Fax Number | 9204683490 |
| Mailing Telephone | 9204684642 |
| Mailing Fax Number | 9204683490 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JAMES L SCHMONSKY III (OPTOMETRIST) |
| Authorized Official Telephone | 9204684642 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1643-035 | WI | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 38403100 | 05 |
| Street Address |
2430 E MASON ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54302-3759 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629408745 | John Simonet | Pharmacist | 2430 E Mason St, Green Bay, WI 54302-3759 | 2013-11-26 |
| 1154768547 | Susan Gilson | Pharmacist | 2430 E Mason St, Green Bay, WI 54302-3759 | 2013-05-27 |
| 1013351287 | Lynn Marie Bond | Pharmacist | 2430 E Mason St, Green Bay, WI 54302-3759 | 2013-04-18 |
| 1144574286 | Christine A Thomas | Pharmacist | 2430 E Mason St, Green Bay, WI 54302-3759 | 2012-10-27 |
| 1578750766 | John Richard Hofmann | Pharmacist | 2430 E Mason St, Green Bay, WI 54302-3759 | 2007-10-01 |
| 1538205380 | Gail P Bosco | Physician Assistant | 2430 E Mason St, Green Bay, WI 54302-3759 | 2007-01-29 |
| 1881797462 | Josephine M Mcintosh | Nurse Practitioner | 2430 E Mason St, Green Bay, WI 54302-3759 | 2006-09-07 |
| 1316049943 | Jennifer Ann Lenius | Physician Assistant | 2430 E Mason St, Green Bay, WI 54302-3759 | 2006-09-03 |
| 1609896042 | James L Schmonsky IIi | Optometrist | 2430 E Mason St, Green Bay, WI 54302-3759 | 2006-07-20 |
| 1003862442 | Shopko Stores Operating Co LLC | Pharmacy | 2430 E Mason St, Green Bay, WI 54302-3759 | 2006-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659721371 | Carissa Marie Sawicki | Counselor | 1234 Main Street, Suite 21, 3rd Floor, Green Bay, WI 54302 | 2016-06-14 |
| 1891181459 | Shannon Rae Mullins | Registered Nurse | 2254 Imperial Ln, Green Bay, WI 54302 | 2015-04-10 |
| 1346667045 | David Howard Jadin | Dentist | 1245 Main St, Green Bay, WI 54302 | 2014-03-20 |
| 1407003577 | Abby Baumgart | Counselor | 1234-21 Main St, Green Bay, WI 54302 | 2008-08-20 |
| 1447441779 | Muller Eyecare Associates Ltd | Optometrist | 1776 E Mason St, Green Bay, WI 54302 | 2007-08-01 |
| 1851385231 | Bornemann Nursing Home Inc | Skilled Nursing Facility | 226 Bornemann St, Green Bay, WI 54302 | 2005-08-31 |
| 1194188706 | Familia Dental Green Bay LLC | Dentist | 1931 Main St., Green Bay, WI 54302 | 2016-03-31 |
| 1255710125 | Kim Lawrence | Social Worker | 1234 Main St., St 21, 3rd Floor, Green Bay, WI 54302 | 2015-05-26 |
| 1255464533 | John Muller | Optometrist | 1776 E Mason St, Green Bay, WI 54302 | 2007-03-14 |
| 1851622005 | Michael Andrew Larkey | Social Worker | 815 Reber St, Green Bay, WI 54302-1116 | 2010-01-27 |
| Find all providers in zip 54302 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861054314 | Myeyedr Optometry of Wisconsin, LLC | Optometrist | 535 S Monroe Ave, Green Bay, WI 54301-4017 | 2019-07-05 |
| 1588177539 | Voss Eyecare Sc | Optometrist | 605 S Military Ave, Green Bay, WI 54303-2211 | 2017-11-13 |
| 1922440429 | Jessica Hilbert | Optometrist | 2461 Holmgren Way, Green Bay, WI 54304-5224 | 2013-07-24 |
| 1780971499 | Craig Alan Keller | Optometrist | 301 Bay Park Square, Green Bay, WI 54304-5104 | 2011-07-01 |
| 1902104946 | Howard Vision Clinic Inc | Optometrist | 2149 Velp Ave Ste 100, Green Bay, WI 54303-5424 | 2011-02-28 |
| 1275845414 | Michelle Schleis | Optometrist | 2851 University Ave, Green Bay, WI 54311-5855 | 2010-07-03 |
| 1336322502 | T.j. Pease & Associates, S.c. | Optometrist | 2324 University Ave, Green Bay, WI 54302-4536 | 2007-12-11 |
| 1447441779 | Muller Eyecare Associates Ltd | Optometrist | 1776 E Mason St, Green Bay, WI 54302 | 2007-08-01 |
| 1699974980 | Eye Associates of Green Bay, Sc | Optometrist | 2020 Riverside Dr Ste 201, Green Bay, WI 54301-2300 | 2007-07-16 |
| 1508903766 | Randall J Paye | Optometrist | 1515 6th St, Green Bay, WI 54304-2272 | 2007-01-30 |
| Find all providers in GREEN BAY | ||||
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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.