NPIMap

Organization Active NPI

Wal-Mart Stores East, LP

Doing business as Wal-Mart Vision Center 30-3835

  • Optician
  • Ooltewah, TN
National Provider Identifier
1467517102
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
WAL-MART STORES EAST, LP
Doing business as
Wal-Mart Vision Center 30-3835
Practice address
5588 Little Debbie Pkwy
Ooltewah, TN 37363-4356
Phone
(423) 238-1069
NPI assigned
Dec 22, 2006
Last updated
Dec 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Authorized official

Name
BJ Rice
Title
Provider Enrollment Specialist
Phone
(479) 277-9835

Specialties & licenses 2

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

Addresses

Primary practice location

5588 Little Debbie Pkwy
Ooltewah, TN 37363-4356

Mailing address

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

Other names 1

  • Wal-Mart Vision Center 30-3835 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network4,654 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

Locations

5588 Little Debbie Pkwy
Ooltewah, TN 37363
Phone (423) 238-0186

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640131200000",
    "number": "1467517102",
    "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": "5588 LITTLE DEBBIE PKWY",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373634356",
            "telephone_number": "423-238-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES EAST, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "BJ",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "479-277-9835"
    },
    "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": "Wal-Mart Vision Center 30-3835",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wal-Mart Vision Center 30-3835",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ooltewah, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.