Walmart Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

938 Issued in IA

Legal business name

WALMART INC.

Practice address

2014 Kittyhawk Rd
Carroll, IA 51401-2172

Phone

(712) 792-3033

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) 853-0515

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• WALMART PHARMACY 10-1787 Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA2 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
  • Grimes, IA
  • NPI 1891000147
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Spencer, IA
  • NPI 1740361740
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Decorah, IA
  • NPI 1750462800
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Waterloo, IA
  • NPI 1801977608
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Optician
  • Marion, IA
  • NPI 1811078009
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Mt Pleasant, IA
  • NPI 1811078637
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Ames, IA
  • NPI 1831637818
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Sioux Center, IA
  • NPI 1891166294
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Ankeny, IA
  • NPI 1750308136
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Denison, IA
  • NPI 1811914294
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Maquoketa, IA
  • NPI 1821015207
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Altoona, IA
  • NPI 1821015215
  NPD tax ID

Locations

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1831116227",
    "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": "2014 KITTYHAWK RD",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514012172",
            "telephone_number": "712-792-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALMART INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A",
        "authorized_official_last_name": "CANONIC",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SENIOR DIRECTOR, ENROLLMENT",
        "authorized_official_telephone_number": "480-853-0515"
    },
    "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": "IA",
            "license": "938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000037347",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2028898",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85555",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0085555",
            "state": "IA"
        }
    ],
    "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 10-1787",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan Vonnahme, PHARMD
• Benjamin Wachholtz, DDS
• Denise Wade, PHARM D
• Wal-Mart Stores, Inc.
• Walgreen Co
• Luann Walsh
• Rosemary C Watchorn, MS, RD, LD
• Katrina (Tina) K Wederquist Zanders, MS, LMSW
• Dorinda Wehde, MS, CADC
• Wellendorf ENT, P.C.

• Community/Retail Pharmacy in Carroll, IA
• Providers in Carroll, IA by specialty
• Community/Retail Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.