NPIMap

Organization Active NPI

Wal-Mart Stores, Inc.

Doing business as Vision Center 30-5477

  • Optician
  • Jefferson City, MO
National Provider Identifier
1861626772
Registry record updated May 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
WAL-MART STORES, INC.
Doing business as
Vision Center 30-5477
Practice address
401 Supercenter Dr
Jefferson City, MO 65101-8190
Phone
(573) 635-3535
NPI assigned
May 6, 2009
Last updated
May 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2009

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

Authorized official

Name
Mrs. Holly C Wilkinson
Title
Carrier Specialist
Phone
(479) 204-8320

Specialties & licenses 2

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

Addresses

Primary practice location

401 Supercenter Dr
Jefferson City, MO 65101-8190

Mailing address

702 SW 8TH Street
Bentonville, AR 72716-0235

Other names 1

  • Vision Center 30-5477 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

401 Supercenter Dr
Jefferson City, MO 65101
Phone (573) 635-3877

NPI Registry JSON

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241568000000",
    "number": "1861626772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH STREET",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SUPERCENTER DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651018190",
            "telephone_number": "573-635-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-06",
        "last_updated": "2009-05-06",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CARRIER SPECIALIST",
        "authorized_official_telephone_number": "479-204-8320",
        "authorized_official_name_prefix": "Mrs."
    },
    "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 30-5477",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; 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.