WALMART PHARMACY 10-1925 – Community/Retail Pharmacy, NPI 1770500811

WALMART PHARMACY 10-1925 is a healthcare provider. based in Newport, Oregon. specializing in Community/Retail Pharmacy. The organization holds a License No. 0001272CS (OR). The NPI Number for WALMART PHARMACY 10-1925 is 1770500811

Main info

Organization
Name
WALMART PHARMACY 10-1925
NPI
1770500811
Phone
(541) 265-6076
Address
160 NW 25TH ST
Authorized Official
KIMBERLY CANONIC SENIOR DIRECTOR, ENROLLMENT
Enumeration Date
16 July 2006
Last Update Date
10 June 2025

Contacts

Main Contact
https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness90
Years active:19State licenses:1Updated within 12 months

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Provider Addresses for WALMART PHARMACY 10-1925

  • 160, 25th Street, Newport Heights, Newport Beach, Orange County, California, 92663, United States

    NEWPORT, OR 973651637

    Phone: (541) 265-6076

    Type: Location

  • Walmart Home Office Main Entrance, 702, Southwest 8th Street, Bentonville, Benton County, Arkansas, 72712, United States

    BENTONVILLE, AR 727160445

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-30

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-12-31 (166 days ago).

Enrollment records

1

Earliest due date

2025-12-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20100930009479OPharmacyOR2025-12-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0008Administration of influenza virus vaccine301301$0
90662Influenza vaccine split virus, preservative free285285$0
90480Admn sarscov2 vacc 1 dose240240$0
91322Sarscov2 vac 50 mcg/0.5ml im238238$0
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count18226$0
View full utilization report →

Insurance plans in this area (ZIP 97365)

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Reviews

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Frequently asked questions

Does WALMART PHARMACY 10-1925 have a public NPI I can cite?
Public records show WALMART PHARMACY 10-1925 under NPI 1770500811.
Is WALMART PHARMACY 10-1925's NPI status active today?
Active status means WALMART PHARMACY 10-1925's NPI record is not deactivated in the public file.
How should patients interpret WALMART PHARMACY 10-1925's specialty?
The extract shows Community/Retail Pharmacy for WALMART PHARMACY 10-1925. Clinical services aligned with this taxonomy classification.
What geographic area is tied to WALMART PHARMACY 10-1925?
WALMART PHARMACY 10-1925 is associated with Newport, Oregon in the same public data insurers reference.
Why is information missing for WALMART PHARMACY 10-1925?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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