Forrest P Wall, M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

10089R Issued in LA

Practice address

385 Bert Kouns Industrial Loop Ste 100
Shreveport, LA 71106-8159

Phone

(318) 221-1629

Fax

(318) 221-6308

NPI assigned

Nov 25, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Plastic and Reconstructive Surgery

Education

University of Texas Medical Branch at Galveston, 1992

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Plastic Surgery Center LLP

  • Plastic and Reconstructive Surgery Physician
  • Shreveport, LA
  • NPI 1700929874
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1699758474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 BERT KOUNS INDUSTRIAL LOOP BLDG 100",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711068124",
            "telephone_number": "318-221-1629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 BERT KOUNS INDUSTRIAL LOOP STE 100",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711068159",
            "telephone_number": "318-221-1629",
            "fax_number": "318-221-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "FORREST",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-25",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "LA",
            "license": "10089R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherry B Walker, PA
• Susannah P Walker, MD
• Suzette Walker
• Tyreunte Walker
• April Wilson Wall, DPT
• Holly Casey Wall, MD, FACS
• Simeon Wall Jr., MD, FACS
• Simeon H. Wall Sr., M.D.
• Wendell E. Wall, M.D.
• Aleric 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 Jul 12, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.