1. Home
  2. Directory
  3. Louisiana
  4. Shreveport
  5. Specialist
  6. NPI Profile

DR. SIMEON H. WALL SR. M.D.
NPI 1700939147
Specialist in Shreveport, LA

Active since January 19, 2007PECOS Enrolled
8600 FERN AVE, SHREVEPORT, LA 71105(318) 795-0801(318) 795-9492 Get Directions Write a Review

NPPES record last updated: February 22, 2012. Verified against the NPPES registry weekly; last sync: October 11, 2026.

About Dr. Simeon H. Wall Sr. M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SIMEON H. WALL SR. M.D. (NPI 1700939147) is an individual specialist in Shreveport, Louisiana, licensed in Louisiana (02970R) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1700939147
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. SIMEON H. WALL SR.Credential: M.D.
Location Address8600 FERN AVEShreveport, LA 71105-5639
Mailing Address8600 Fern AveShreveport, LA 71105-5639 · (318) 795-0801 · Fax (318) 795-9492
Phone(318) 795-0801
Fax(318) 795-9492
Sole ProprietorYes
Enumeration DateJanuary 19, 2007
Last NPPES UpdateFebruary 22, 2012
✔ NPI 1700939147 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in LA · 02970R
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
8600 FERN AVE, Shreveport, LA 71105
Open in Google Maps ↗

Other Identifiers 2

Medicare ID-Type Unspecified5L694LA · Plastic Surgery
Medicare UPINB61438LA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Simeon H. Wall Sr. M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOLLY CASEY WALL MD, FACS
Surgery (Plastic and Reconstructive Surgery)
8600 FERN AVE
SHREVEPORT, LA 71105
Caddo Parish (318) 795-0801
SIMEON WALL JR. MD, FACS
Surgery (Plastic and Reconstructive Surgery)
8600 FERN AVE
SHREVEPORT, LA 71105
Caddo Parish (318) 795-0801
MRS. JEANNIE SHIM MCALLISTER PA-C
Physician Assistant (Medical)
8600 FERN AVE
SHREVEPORT, LA 71105
Caddo Parish (318) 213-1772
SIMEON H. WALL, MD A PROFESSIONAL MEDICAL CORP
Plastic Surgery
8600 FERN AVE
SHREVEPORT, LA 71105
Caddo Parish (318) 795-0801

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Simeon Wall's NPI number?

The NPI number for Simeon Wall is 1700939147. It was assigned to this individual provider in the NPPES registry on January 19, 2007.

Where is Simeon Wall located?

Simeon Wall practices at 8600 Fern Ave, Shreveport, LA 71105. The listed phone number is (318) 795-0801.

What is Simeon Wall's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Simeon Wall enrolled in Medicare?

Yes. Simeon Wall is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Simeon Wall was last updated on February 22, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.