OrganizationActive
Wal-Mart Stores East, Lp
NPI 1558239830 · Eyewear Supplier · Jacksonville, FL
Wal-Mart Stores East, Lp is a Eyewear Supplier organization in Jacksonville, FL (NPI 1558239830).
Provider details
- NPI number
- 1558239830
- Entity type
- Organization
- Primary specialty
- Eyewear SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Kimberly Canonic, Director of Health Care Contracting(480) 277-6348
Specialties & taxonomies
Suppliers
- Optician156FX1800X
Eye and Vision Services Providers
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in 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
10000 Omni Dr
Jacksonville, FL 32222-4171
Phone: (904) 934-6920
Approximate (ZIP-level) locationGet directions
Mailing address
1 Customer Dr
Bentonville, AR 72716-0445
Registry dates
- Enumerated
- 2025-10-28
- Last updated
- 2025-10-28
- Certified
- 2025-10-28
Frequently asked questions
- What is Wal-Mart Stores East, Lp's NPI number?
- Wal-Mart Stores East, Lp's National Provider Identifier (NPI) is 1558239830, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Wal-Mart Stores East, Lp?
- Wal-Mart Stores East, Lp is classified in the NPPES registry as Eyewear Supplier (Suppliers).
- Where is Wal-Mart Stores East, Lp located?
- Wal-Mart Stores East, Lp's practice location on file with NPPES is 10000 Omni Dr, Jacksonville, FL 32222-4171.
- What is Wal-Mart Stores East, Lp's phone number?
- The practice phone number listed in the NPPES registry for Wal-Mart Stores East, Lp is (904) 934-6920.
- Who is the authorized official for Wal-Mart Stores East, Lp?
- The authorized official listed on Wal-Mart Stores East, Lp's NPPES record is Kimberly Canonic, Director of Health Care Contracting. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Wal-Mart Stores East, Lp's NPI active?
- Yes — Wal-Mart Stores East, Lp's NPI (1558239830) is active in the NPPES registry as of the last update on 2025-10-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.