OrganizationActive
Wal-Mart Stores, Inc
NPI 1114017357 · Eyewear Supplier · Ponderay, ID
Wal-Mart Stores, Inc is a Eyewear Supplier organization in Ponderay, ID (NPI 1114017357).
Provider details
- NPI number
- 1114017357
- Entity type
- Organization
- Primary specialty
- Eyewear SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Nicole Gentile, Npi Coordinator(316) 788-5580
Specialties & taxonomies
Suppliers
- Optician156FX1800X
Eye and Vision Services Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
476999 Highway 95
Ponderay, ID 83852-9738
Phone: (208) 265-8332
Street-level locationGet directions
Mailing address
702 Sw 8th St
Bentonville, AR 72716-0235
Other names (DBA / former)
- Doing business as
- Vision Center 30-2485
Registry dates
- Enumerated
- 2006-10-16
- Last updated
- 2025-09-11
Frequently asked questions
- What is Wal-Mart Stores, Inc's NPI number?
- Wal-Mart Stores, Inc's National Provider Identifier (NPI) is 1114017357, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Wal-Mart Stores, Inc?
- Wal-Mart Stores, Inc is classified in the NPPES registry as Eyewear Supplier (Suppliers).
- Where is Wal-Mart Stores, Inc located?
- Wal-Mart Stores, Inc's practice location on file with NPPES is 476999 Highway 95, Ponderay, ID 83852-9738.
- What is Wal-Mart Stores, Inc's phone number?
- The practice phone number listed in the NPPES registry for Wal-Mart Stores, Inc is (208) 265-8332.
- Who is the authorized official for Wal-Mart Stores, Inc?
- The authorized official listed on Wal-Mart Stores, Inc's NPPES record is Nicole Gentile, Npi Coordinator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Wal-Mart Stores, Inc's NPI active?
- Yes — Wal-Mart Stores, Inc's NPI (1114017357) is active in the NPPES registry as of the last update on 2025-09-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.