NPIMap

Organization Active NPI

Walmart Inc.

Doing business as Vision Center 30-5404

  • Optician
  • Homewood, IL
National Provider Identifier
1316020993
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
WALMART INC.
Doing business as
Vision Center 30-5404
Practice address
17550 Halsted St
Homewood, IL 60430-2001
Phone
(708) 755-1330
Fax
(708) 755-1476
NPI assigned
Oct 24, 2006
Last updated
Dec 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Authorized official

Name
Michele Garvey
Title
Senior Director II, Billing
Phone
(479) 277-2611

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FX1800X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

17550 Halsted St
Homewood, IL 60430-2001

Mailing address

702 SW 8TH St.
Bentonville, AR 72716-0235

Other names 1

  • Vision Center 30-5404 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 24

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

View all 24

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": "1670371200000",
    "number": "1316020993",
    "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": "17550 HALSTED ST",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302001",
            "telephone_number": "708-755-1330",
            "fax_number": "708-755-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALMART INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "GARVEY",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "SENIOR DIRECTOR II, BILLING",
        "authorized_official_telephone_number": "479-277-2611"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Center 30-5404",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vision Center 30-5404",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.