Walmart Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054016089 Issued in IL

Legal business name

WALMART INC.

Practice address

1275 Lake Ave
Woodstock, IL 60098-7415

Phone

(815) 206-0938

NPI assigned

Dec 27, 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 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL2 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.

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 15

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

• Wal-Mart Pharmacy Inc West

  • Community/Retail Pharmacy
  • Mt Prospect, IL
  • NPI 1962429241
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • Normal, IL
  • NPI 1942382825
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • Urbana, IL
  • NPI 1972686558
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • Springfield, IL
  • NPI 1972689420
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • Peoria, IL
  • NPI 1982788535
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • Washington, IL
  • NPI 1992886709
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • Orland Hills, IL
  • NPI 1992886808
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • Shorewood, IL
  • NPI 1992888549
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Woodstock, IL
  • NPI 1962567867
  NPD tax ID
• Wal-Mart Stores, Inc. Dba Wal-Mart

  • Eyewear Supplier
  • Lincoln, IL
  • NPI 1982734539
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Belvidere, IL
  • NPI 1942227244
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Hodgkins, IL
  • NPI 1952328239
  NPD tax ID

Locations

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1992860019",
    "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": "1275 LAKE AVE",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987415",
            "telephone_number": "815-206-0938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALMART INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054016089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2023280",
            "state": null
        }
    ],
    "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": []
}

• Jessica Wagner, PT
• Wal-Mart Stores, Inc.
• Walgreen Co
• Walgreen Co.
• Claire Walker
• Lawrence Thomas Walsh Jr.
• Wendy L. Ward, M.D.
• David Washington, MSW
• Lisa Jean Washkowiak, M.A., CCC-SLP/L
• Holly Noel Watson-Evans, MS, FNP-BC

• Community/Retail Pharmacy in Woodstock, IL
• Providers in Woodstock, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.