{"npi":"1164474698","type":"NPI-2","status":"active","name":{"display":"Shopko Stores Operating Co. LLC","other":[],"organization_name":"SHOPKO STORES OPERATING CO. LLC","authorised_official":"Michael Bettiga"},"specialty":{"primary_taxonomy":"332H00000X","primary_taxonomy_description":"Eyewear Supplier","slug":"eyewear-supplier","schema_org_specialty":null,"all":[{"code":"332H00000X","description":"Eyewear Supplier","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"2208 N WEBB RD","city":"GRAND ISLAND","state":"NE","postal_code":"688031739","country_code":"US","phone":"3083827661"},{"purpose":"MAILING","street_1":"2208 N WEBB RD","city":"GRAND ISLAND","state":"NE","postal_code":"688031739","country_code":"US","phone":"3083827661"}],"license":null,"identifiers":[{"type_code":"01","label":"Other","value":"099548","state":null,"issuer":"MEDICARE"},{"type_code":"01","label":"Other","value":"17882","state":null,"issuer":"MEDICARE"},{"type_code":"01","label":"Other","value":"914651","state":null,"issuer":"BLOCK"},{"type_code":"05","label":"Medicaid","value":"10025074000","state":"NE","issuer":null},{"type_code":"01","label":"Other","value":"014038","state":null,"issuer":"VIP"},{"type_code":"01","label":"Other","value":"213121-23","state":null,"issuer":"EYEMED"},{"type_code":"01","label":"Other","value":"35496","state":null,"issuer":"AVESIS"},{"type_code":"01","label":"Other","value":"35858","state":null,"issuer":"DAVIS"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-05-16","last_updated":"2008-02-11","_meta":{"source":"NPPES","snapshot_date":"2008-02-11","doc_url":"https://findmynpi.com/api"}}