Active NPI
Donald Walker, OD
- Optometrist
- Shreveport, LA
National Provider Identifier
1386639110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 809097T
- Practice address
- 6823 Pines Rd
Suite B
Shreveport, LA 71129-5205 - Phone
- (318) 688-3050
- Fax
- (318) 688-3233
- NPI assigned
- Sep 19, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 809097T | LA | Primary |
| Eyewear Supplier | 332H00000X | 152W00000X | LA |
Addresses
Primary practice location
6823 Pines Rd
Suite B
Shreveport, LA 71129-5205
Mailing address
6823 Pines Rd
Suite B
Shreveport, LA 71129-5205
Phone (318) 688-3050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1342696 | Medicaid | LA |
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: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 809097T | LA | MD | Optometrist |
| 152W00000X | LA | MD | Eyewear Supplier |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lusk Eye Specialists, LLC | Optometrist | Current | Accepting new patients |
Locations
451 Ashley Ridge Blvd
Shreveport, LA 71106
Phone (318) 222-5555
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229385600000",
"number": "1386639110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6823 PINES RD",
"address_2": "SUITE B",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711295205",
"telephone_number": "318-688-3050",
"fax_number": "318-688-3233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6823 PINES RD",
"address_2": "SUITE B",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711295205",
"telephone_number": "318-688-3050",
"fax_number": "318-688-3233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "DONALD",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-19",
"last_updated": "2008-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "LA",
"license": "809097T",
"primary": true
},
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": "LA",
"license": "152W00000X",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1342696",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.