Wal-Mart Stores East, LP

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

WAL-MART STORES EAST, LP

Doing business as

Walmart Vision Center 30-6397

Practice address

15601 SW 127TH Ave
Miami, FL 33177-1406

Phone

(305) 235-4440

Fax

(305) 235-4441

NPI assigned

Sep 17, 2021

Last updated

Sep 17, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sarah Little

Title

Director of Health Care Contracting

Phone

(479) 277-2500

Specialties & licenses 2

Addresses

Other names 1

• Walmart Vision Center 30-6397 Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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

{
    "created_epoch": "1631836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631836800000",
    "number": "1659041945",
    "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",
            "telephone_number": "479-277-2500",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15601 SW 127TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331771406",
            "telephone_number": "305-235-4440",
            "fax_number": "305-235-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES EAST, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-17",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "DIRECTOR OF HEALTH CARE CONTRACTING",
        "authorized_official_telephone_number": "479-277-2500"
    },
    "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": "Walmart Vision Center 30-6397",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wal-Mart Stores East LP (WalMart Pharmacy 10-5854)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-4303)
• Wal-Mart Stores East LP (WalMart Pharmacy 10-5912)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-4140)
• Wal-Mart Stores East, LP (Walmart Vision Center 30-4303)
• Wal-Mart Stores East, LP (Walmart Pharmacy 10-5719)
• Wal-Mart Stores East, LP (Walmart Pharmacy 10-6397)
• Kiara Brandie Walcott, PHARMD
• Joseph Caleb Walcutt, PA-C
• Katherine Wald, L.C.S.W

• Optician in Miami, FL
• Providers in Miami, FL by specialty
• Optician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.