Dr R C Shackelford Optometrist

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DR R C SHACKELFORD OPTOMETRIST

Doing business as

Shackelford Family Eyecare

Practice address

2350 Mount Pleasant Rd
Hernando, MS 38632-1909

Phone

(662) 429-4448

Fax

(662) 429-5975

NPI assigned

Jun 26, 2008

Last updated

May 5, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Raymond Calvin Shackelford, ODNPI 1558499640

Title

Owner

Phone

(662) 429-4448

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SHACKELFORD FAMILY EYECARE Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Raymond Calvin Shackelford, OD

  • Optometrist
  • Hernando, MS
  • NPI 1558499640
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777939200000",
    "number": "1306008719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8815 MILLBRANCH RD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386712312",
            "telephone_number": "662-393-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 MOUNT PLEASANT RD",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386321909",
            "telephone_number": "662-429-4448",
            "fax_number": "662-429-5975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR R C SHACKELFORD OPTOMETRIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A",
        "authorized_official_last_name": "SHACKELFORD",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "CALVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-429-4448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00087049",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHACKELFORD FAMILY EYECARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SHACKELFORD FAMILY EYECARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angela Renee Devault, MSW, CMHT
• Katherine Diggs, P.T.
• Chiquaisha Done Strong
• Elizabeth Paige Dougher
• Dr Michael Lyons Proffessional Corporation
• Dr. Michael Lyons PC
• Rebecca Haley Drew, PT, DPT
• Kamela Duncan, LPC
• Danton Dye, DC
• E D Medical Care

• Optometrist in Hernando, MS
• Providers in Hernando, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.