Active NPI
Casey Anne Wall, PHARM. D.
- Pharmacist
- Bossier City, LA
National Provider Identifier
1568743441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 018470
- Practice address
- 3400 Airline Dr
Bossier City, LA 71111-2122 - Phone
- (318) 741-6589
- NPI assigned
- Sep 6, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 018470 | LA | Primary |
Addresses
Primary practice location
3400 Airline Dr
Bossier City, LA 71111-2122
Mailing address
6149 Lovers LN
Shreveport, LA 71105-4829
Phone (318) 518-6821
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018470 | LA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315267200000",
"number": "1568743441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6149 LOVERS LN",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711054829",
"telephone_number": "318-518-6821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 AIRLINE DR",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711112122",
"telephone_number": "318-741-6589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "CASEY",
"middle_name": "ANNE",
"credential": "PHARM. D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-06",
"last_updated": "2011-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "018470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bossier City, LA
- Walgreen Co (Walgreens #09998)
- Walgreen Co (Walgreens #07004)
- Walgreen Co. (Walgreens #21523)
- Ashley Walker, PHARM.D.
- Shytrinity Jett Walker, RN
- Cindy Jean Andrews Wallace, R.D., L.D.N., M.B.A
- Lauren Marie Wallace, PA-C
- Nicholas Preston Wallace, LPC, NCC, CCMHC
- Sadie Noelle Wallace
- Tarkisha Wallace, LPC-S, NCC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.