Active NPI
Wal-Mart Stores, Inc.
Doing business as Vision Center 30-0196
- Eyewear Supplier
- Carbondale, IL
National Provider Identifier
1255414892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- WAL-MART STORES, INC.
- Doing business as
- Vision Center 30-0196
- Practice address
- 1450 E Main St
Carbondale, IL 62901-3140 - Phone
- (618) 457-2033
- NPI assigned
- Oct 24, 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
- Nicole D Gentile
- Title
- Npi Coordinator
- Phone
- (316) 788-5580
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | |||
| Eyewear Supplier | 332H00000X | Primary |
Addresses
Primary practice location
1450 E Main St
Carbondale, IL 62901-3140
Mailing address
702 SW 8TH St.
Bentonville, AR 72716-0235
Other names 1
- Vision Center 30-0196
National Provider Directory
National Provider Directory- Tax ID family
- Ability Network
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.
-
dba Walmart Vision Center 30-4049
- Eyewear Supplier
- Olympia Fields, IL
- NPI 1235684135
-
dba Vision Center 30-1386
- Eyewear Supplier
- Pontiac, IL
- NPI 1225168750
-
- Pharmacy
- Collinsville, IL
- NPI 1255865853
-
- Community/Retail Pharmacy
- Northlake, IL
- NPI 1215954599
-
- Community/Retail Pharmacy
- Collinsville, IL
- NPI 1225055502
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1255414892",
"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": "727160235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 E MAIN ST",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629013140",
"telephone_number": "618-457-2033"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WAL-MART STORES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-24",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "GENTILE",
"authorized_official_first_name": "NICOLE",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "NPI COORDINATOR",
"authorized_official_telephone_number": "316-788-5580"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": null,
"primary": false
},
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Vision Center 30-0196",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Carbondale, IL
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.