WAL-MART STORES EAST, LP (NPI# 1114332665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114332665 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST, LP |
| Other Organization Name | WALMART CARE CLINIC 10-0511 |
| Practice Address |
1283 Broad St Sumter SC 29150-1973 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 8039055528 |
| Practice Fax Number | 8039055530 |
| Mailing Telephone | 4792048550 |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2015-02-19 |
| Authorized Official Name | LAURA LEVINE (DIRECTOR OF HEALTHCARE CONTRACTING) |
| Authorized Official Telephone | 4792048550 |
| Is Organization Subpart | Y |
| Parent Organization Name | WAL-MART STORES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | MEDICARE PTAN | D953 | 01 |
| SC | GP6498 | 05 |
| Other Name | Type Code |
|---|---|
| Walmart Care Clinic 10-0511 | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730798851 | Wal-mart Stores East, Lp | Technician/Technologist | 461 Rt 10 Suite A100, Ledgewood, NJ 07852 | 2020-07-24 |
| 1184156317 | Wal-mart Stores East, Lp | Durable Medical Equipment & Medical Supplies | 270 Heald Way, The Villages, FL 32163-6003 | 2017-03-28 |
| 1730611971 | Wal-mart Stores East, Lp | Durable Medical Equipment & Medical Supplies | 4401 Poole Rd., Raleigh, NC 27603-0000 | 2017-03-28 |
| 1720527955 | Wal-mart Stores East, Lp | Technician/Technologist | 2755 W Holton-whitehall Rd, Whitehall, MI 49461 | 2017-02-21 |
| 1003354580 | Wal-mart Stores East, Lp | Technician/Technologist | 2129 Grand Ave, Yazoo City, MS 39194 | 2017-02-06 |
| 1255874970 | Wal-mart Stores East, Lp | Technician/Technologist | 3410 Sw Market St, Lees Summit, MO 64082 | 2016-11-29 |
| 1538611066 | Wal-mart Stores East, Lp | Technician/Technologist | 546 First Colonial Road, Virginia Beach, VA 23451 | 2016-11-01 |
| 1760933196 | Wal-mart Stores East, Lp | Durable Medical Equipment & Medical Supplies | 1705 S Kings Hwy, Myrtle Beach, SC 29577-4601 | 2016-10-20 |
| 1700335312 | Wal-mart Stores East, Lp | Durable Medical Equipment & Medical Supplies | 3045 Sw Port St Lucie Blvd, Port St Lucie, FL 34953-0000 | 2016-09-23 |
| 1619425683 | Wal-mart Stores East, Lp | Technician/Technologist | 11930 Narcoossee Road, Orlando, FL 32832-0000 | 2016-09-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | WAL-MART STORES EAST, LP | 708 Sw 8th Street, Bentonville, AR 72716 |
| Massachusetts Corporations | WAL-MART STORES EAST, LP | 702 Sw 8th Street, Bentonville, AR 72716 |
| Oklahoma Business Registrations | WAL-MART STORES EAST, LP | 702 Sw 8th Street, Bentonville, AR 72716 |
| Oregon Corporations, Companies and Business Names | WAL-MART STORES EAST, LP, A LIMITED PARTNERSHIP OF DELAWARE | 708 Sw 8th Street, Bentonville, AR 72716 |
| Street Address |
1283 BROAD ST |
| City | SUMTER |
| State | SC |
| Zip Code | 29150-1973 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174541973 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1283 Broad St, Sumter, SC 29150-1973 | 2006-07-18 |
| 1316488836 | Mary Jane Mcmanus | Nurse Practitioner | 1283 Broad St, Sumter, SC 29150 | 2017-03-16 |
| 1083010375 | Steve Christmas | Pharmacist | 1283 Broad St, Pharmacy, Sumter, SC 29150-1973 | 2014-11-13 |
| 1518105980 | Doctors Eye Center, Pa | Optometrist | 1283 Broad St, Sumter, SC 29150-1973 | 2009-01-23 |
| 1417039744 | Wal-mart Stores East, Lp | Technician/Technologist | 1283 Broad St, Sumter, SC 29150-1973 | 2006-10-19 |
| 1649289539 | Stephen Gregory Buck | Optometrist | 1283 Broad St, Sumter, SC 29150-1973 | 2006-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174152557 | Stacey Delene Mcconico | Adult Companion | 201 East Liberty Street, Sumter, SC 29150 | 2020-04-07 |
| 1780227942 | Add Light Home Care LLC | In Home Supportive Care | 698-s Bultman Dr, Suite C-8, Sumter, SC 29150 | 2019-10-21 |
| 1770044075 | Kimberly A Weeks | Technician, Other | 5 E Liberty Street, Sumter, SC 29150 | 2019-03-28 |
| 1689155103 | Chrishena E Craig | Social Worker | 801 N. Pike West, Sumter, SC 29150 | 2018-08-23 |
| 1093200735 | Michael B Coseo | Dietitian, Registered | 1278 N. Lafayette Drive, Sumter, SC 29150 | 2018-06-26 |
| 1790287258 | Keever Murdaugh | Physical Therapy Assistant | 1018 North Guignard Drive, Sumter, SC 29150 | 2018-03-01 |
| 1679094643 | James D Pearson | Emergency Medical Technician, Basic | 9b Willow Drive, Sumter, SC 29150 | 2017-06-29 |
| 1245771781 | Shanekia Littles | In Home Supportive Care | 251 Rast St Unit D-1, Sumter, SC 29150 | 2017-03-16 |
| 1326590415 | Believe In Faith Home Care | In Home Supportive Care | 410 W Liberty St Suite 102, Sumter, SC 29150 | 2016-10-25 |
| 1912368457 | Urology Clinic, Inc. | Urology | 1285 Wilson Hall Rd, Sumter, SC 29150 | 2016-03-11 |
| Find all providers in zip 29150 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962479170 | K. Patricia Miller Derajtys | Nurse Practitioner | 1278 N Lafayette Drive, Sumter, SC 29150 | 2006-03-07 |
| 1932708146 | Latroy Omar Dingle | Nurse Practitioner | 100 W Liberty St, Sumter, SC 29150-5142 | 2020-10-19 |
| 1568925337 | Paula Mcknight-leggette | Nurse Practitioner | 129 N Washington St, Sumter, SC 29150 | 2019-04-09 |
| 1396267340 | Mcleod Physician Associates II | Nurse Practitioner | 540 Physicians Ln, Sumter, SC 29150-3370 | 2017-07-12 |
| 1275071300 | Chasity Shadoan | Nurse Practitioner | 641 W Wesmark Blvd, Sumter, SC 29150-1900 | 2017-02-09 |
| 1225467707 | Barbara Carden | Nurse Practitioner | 625 W Wesmark Blvd, Sumter, SC 29150-1900 | 2013-11-05 |
| 1952643124 | Lillian Stukes-douglas | Nurse Practitioner | 325 Broad St, Suite 100, Sumter, SC 29150-4167 | 2013-03-26 |
| 1124276233 | Carla Michelle Foley | Nurse Practitioner | 115 N Sumter St, Suite 115, Sumter, SC 29150-4972 | 2008-09-03 |
| 1720112618 | Gwen Gray Girdler | Nurse Practitioner | 1278 N Lafayette Dr, Sumter, SC 29150-2964 | 2007-03-15 |
| 1700919842 | Mary Jean Sturgis | Nurse Practitioner | 129 N Washington St, Sumter, SC 29150-4949 | 2007-03-14 |
| Find all providers in SUMTER | ||||
Please comment or provide details below to improve the information on WAL-MART STORES EAST, LP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.