NPIMap

Organization Active NPI

Wal-Mart Stores, Inc

Doing business as Vision Center 30-4284

  • Optician
  • Lakewood, CO
National Provider Identifier
1003964776
Registry record updated Sep 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
WAL-MART STORES, INC
Doing business as
Vision Center 30-4284
Practice address
440 Wadsworth Blvd
Lakewood, CO 80226-1510
Phone
(303) 205-0772
Fax
(303) 205-0774
NPI assigned
Jan 8, 2007
Last updated
Sep 13, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2007

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

Authorized official

Name
Mr. G Wesley Crainshaw III
Title
Provider Enrollment Specialist
Phone
(479) 277-1850

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU
Optician 156FX1800X NU Primary

Addresses

Primary practice location

440 Wadsworth Blvd
Lakewood, CO 80226-1510

Mailing address

702 SW 8TH Street
Bentonville, AR 72716-0235

Other names 1

  • Vision Center 30-4284 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network2,173 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189641600000",
    "number": "1003964776",
    "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": "440 WADSWORTH BLVD",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802261510",
            "telephone_number": "303-205-0772",
            "fax_number": "303-205-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-09-13",
        "status": "A",
        "authorized_official_last_name": "CRAINSHAW",
        "authorized_official_first_name": "G",
        "authorized_official_middle_name": "WESLEY",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "479-277-1850",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Center 30-4284",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; 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.