Holly Casey Wall, MD, FACS

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

L14095R Issued in LA

Practice address

8600 Fern Ave
Shreveport, LA 71105-5639

Phone

(318) 795-0801

Fax

(318) 795-9492

NPI assigned

Oct 18, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Holly Dawn Casey Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 29, 2016 through Sep 29, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1245229624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 FERN AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055639",
            "telephone_number": "318-795-0801",
            "fax_number": "318-795-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 FERN AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055639",
            "telephone_number": "318-795-0801",
            "fax_number": "318-795-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "HOLLY",
        "middle_name": "CASEY",
        "credential": "MD, FACS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "LA",
            "license": "L14095R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184306",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "CASEY",
            "middle_name": "DAWN",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Susannah P Walker, MD
• Suzette Walker
• Tyreunte Walker
• April Wilson Wall, DPT
• Forrest P Wall, M.D.
• Simeon Wall Jr., MD, FACS
• Simeon H. Wall Sr., M.D.
• Wendell E. Wall, M.D.
• Aleric Wallace
• Ariante Vanae Wallace

• Plastic and Reconstructive Surgery Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Plastic and Reconstructive Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.