Individual provider Active NPI

Forrest O Moore III, M.D.

  • Trauma Surgery Physician
  • Shreveport, LA
National Provider Identifier
1548286693
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
311893 Issued in LA
Practice address
1541 Kings Hwy
Shreveport, LA 71103-4228
Phone
(318) 626-0000
NPI assigned
Jul 14, 2006
Last updated
May 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X M0188 TX
Surgery Physician 208600000X 36453 AZ
Surgical Critical Care Physician 2086S0102X 36453 AZ
Surgical Critical Care Physician 2086S0102X 311893 LA
Surgical Critical Care Physician 2086S0102X M0188 TX
Trauma Surgery Physician 2086S0127X 311893 LA Primary

Addresses

Primary practice location

1541 Kings Hwy
Shreveport, LA 71103-4228

Mailing address

1512 W Kirby PL
Shreveport, LA 71103-3822

Other practice location 1

2401 S 31st St
Temple, TX 76508-4917
Phone (254) 724-2111

Other practice location 2

1400 E Boulder St Ste 500
Colorado Springs, CO 80909-5533
Phone (719) 364-6488

Other identifiers 1

IdentifierTypeStateIssuer
191785MedicaidAZ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fmoore628746@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, LA, AZ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20050715000864 TX Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 4183689151 Reassigns benefits to 2 organizations
I20061207000143 LA Practitioner - General SurgeryPractitioner - Other (Physician) 4183689151 Reassigns benefits to 1 organization
I20070405000170 AZ Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 4183689151 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
Medical College of Wisconsin, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acclaim Physician Group IncGroup PAC ID 4587963582, 520 clinicians
Flagstaff Surgical Associates PAGroup PAC ID 6901880210, 32 clinicians

Practice addresses (Care Compare)

1350 S Main St
Suite 1600
Fort Worth, TX 76104-7611
Phone (817) 702-9701

1350 S Main St FL
1 Healing Wings/Infectious Disease
Fort Worth, TX 76104-7611
Phone (817) 702-3701

1500 S Main St
Fort Worth, TX 76104-4917

1500 S Main St FL
1 Urgent Care Center
Fort Worth, TX 76104-4917
Phone (817) 702-1451

1575 S Main St
Fort Worth, TX 76104-4901
Phone (817) 702-3431

77 W Forest Ave
Suite 201
Flagstaff, AZ 86001-1483
Phone (928) 773-2222

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M0188TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Internal Medicine CurrentSince Mar 1, 2019 Accepting new patients
Scott & White Clinic Internal Medicine Current Accepting new patients
Scott & White Clinic Internal Medicine CurrentSince Jan 13, 2020 Accepting new patients
County of Santa Clara Current Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Acclaim Physician Group, Inc Internal Medicine CurrentSince Oct 17, 2017 Accepting new patients
Scott and White Clinic Internal Medicine CurrentSince Jan 13, 2020 Accepting new patients
Flagstaff Surgical Associates PA Surgical Critical Care PastSince Jul 15, 2002 Accepting new patients
Trauma and Acute Care Surgeons of Northern Arizona Trauma Surgery PastSince Oct 1, 2011 Accepting new patients
East Texas Medical Center Healthcare Associates Surgery Past Accepting new patients
Tarrant County Hospital District Past Accepting new patients
Einstein Practice Plan Inc Surgery Past Accepting new patients

Locations

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Interoperability endpoints

  • Direct secure messaging: fmoore628746@direct.sw.org
  • Direct secure messaging: fmoore777857@direct.ochsner.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/BJDHBD

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1548286693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 W KIRBY PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-626-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 S 31st St",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765084917",
            "country_code": "US",
            "telephone_number": "254-724-2111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 E Boulder St Ste 500",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809095533",
            "country_code": "US",
            "telephone_number": "719-364-6488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "FORREST",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "M0188",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "36453",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "AZ",
            "license": "36453",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "LA",
            "license": "311893",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TX",
            "license": "M0188",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "LA",
            "license": "311893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191785",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fmoore628746@direct.sw.org",
            "affiliation": "N",
            "address_1": "2401 S 31st St",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765084917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.