Individual provider Active NPI

Barron Johns O'Neal, M.D.

  • Plastic Surgery Physician
  • Shreveport, LA
National Provider Identifier
1184685950
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
014595 Issued in LA
Practice address
2210 Line Ave
Suite 204
Shreveport, LA 71104-2152
Phone
(318) 221-9671
Fax
(318) 425-2343
NPI assigned
Mar 31, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 014595 LA Primary

Addresses

Primary practice location

2210 Line Ave
Suite 204
Shreveport, LA 71104-2152

Mailing address

2210 Line Ave
Suite 204
Shreveport, LA 71104-2152
Phone (318) 221-9671

Other identifiers 1

IdentifierTypeStateIssuer
1385336MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100914000548 LA Practitioner - Plastic and Reconstructive Surgery 6709921463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Louisiana State University School of Medicine in Shreveport, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bundrick and O'Neal Plastic Surgery (AMC)Group PAC ID 4082739107, 3 clinicians

Practice addresses (Care Compare)

2210 Line Ave
Suite 200
Shreveport, LA 71104-2152
Phone (318) 221-9671

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy46
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
014595LAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bundrick and O'Neal Plastic Surgery (AMC) Plastic Surgery CurrentSince Jun 15, 1978 Accepting new patients

Locations

2210 Line Ave
Ste 200
Shreveport, LA 71104
Phone (318) 221-9671

2210 Line Ave
Ste 204
Shreveport, LA 71104
Phone (318) 221-9671

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1184685950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 LINE AVE",
            "address_2": "SUITE 204",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042152",
            "telephone_number": "318-221-9671",
            "fax_number": "318-425-2343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 LINE AVE",
            "address_2": "SUITE 204",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042152",
            "telephone_number": "318-221-9671",
            "fax_number": "318-425-2343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEAL",
        "first_name": "BARRON",
        "middle_name": "JOHNS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "LA",
            "license": "014595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1385336",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.