Walmart Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

700000002 Issued in CO

Legal business name

WALMART INC.

Practice address

745 N US Highway 287
Lafayette, CO 80026-8955

Phone

(303) 666-0434

NPI assigned

Jul 16, 2006

Organization subpart

No

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

Authorized official

Name

Kimberly Canonic

Title

Senior Director, Enrollment

Phone

(480) 277-6348

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• WALMART PHARMACY 10-1045 Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Tax ID family

Ability Network2,173 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Colorado Springs, CO
  • NPI 1104908854
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Littleton, CO
  • NPI 1114002532
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Parker, CO
  • NPI 1144303850
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Pueblo West, CO
  • NPI 1144323635
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Denver, CO
  • NPI 1164507745
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Optician
  • Arvada, CO
  • NPI 1164955852
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Montrose, CO
  • NPI 1194808899
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Colorado Springs, CO
  • NPI 1225116270
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Fountain, CO
  • NPI 1265522411
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Longmont, CO
  • NPI 1124185509
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Colorado Springs, CO
  • NPI 1134146400
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Westminster, CO
  • NPI 1134284193
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sejal Patel

  • Pharmacist
  • Lafayette, CO
  • NPI 1790348860
  NPD (past)
• Abubakr Ragab

  • Pharmacist
  • Lafayette, CO
  • NPI 1144963463
  NPD (past)
• Hyesung Yim

  • Pharmacist
  • Lafayette, CO
  • NPI 1336602861
  NPD (past)

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748995200000",
    "number": "1194742452",
    "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": "727160445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 N US HIGHWAY 287",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800268955",
            "telephone_number": "303-666-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALMART INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A",
        "authorized_official_last_name": "CANONIC",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SENIOR DIRECTOR, ENROLLMENT",
        "authorized_official_telephone_number": "480-277-6348"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CO",
            "license": "700000002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2001853",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3007028",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03007028",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "WALMART PHARMACY 10-1045",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Walgreen Co.
• Elizabeth A Walker, D.C.
• Katherine Sears Walker
• Keith Wallin, RPH
• Jessica Walls
• Mary Ware, P.T.,DPT,CBIS
• Dolly Lee Warner, NP
• Gabriella Warner, RD
• Tamara Warren
• Jolene Ann Washington, DO

• All providers in Lafayette, CO
• Community/Retail Pharmacy in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.