Charlotte L Shackelford, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

746 Issued in OK

Practice address

1401 N 4TH Ave
Suite 201
Purcell, OK 73080-1806

Phone

(405) 527-5400

Fax

(405) 527-7332

NPI assigned

Jun 7, 2008

Last updated

Jul 18, 2011By the provider in NPPES

Sex

Female

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 OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Loving Care in-Home Health Services, L.L.C. Home health agency, Noble, OK, CCN 377604
• Purcell Municipal Hospital Hospital, Purcell, OK, CCN 370158
• Norman Regional Hospital, Norman, OK, CCN 370008
• SSM Health St Anthony Hospital - Oklahoma City Hospital, Oklahoma City, OK, CCN 370037
• O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
• SSM Health St Anthony Hospital - Shawnee Hospital, Shawnee, OK, CCN 370149

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Saints Medical Group, LLC

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1437195922
  Medicare reassignment Care Compare group NPD
• Purcell Municipal Hospital

  • General Acute Care Hospital
  • Purcell, OK
  • NPI 1467476911
  Medicare reassignment
• Purcell Municipal Hospital

  dba PMH Emergency Physicians

  • Emergency Medicine Physician
  • Purcell, OK
  • NPI 1306282348
  NPD
• Purcell Municipal Hospital

  dba Family Medicine of Purcell

  • Family Medicine Physician
  • Purcell, OK
  • NPI 1851630404
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Loving Care in-Home Health Services

  • Home Health Agency
  • Noble, OK
  • NPI 1528169497
  Care Compare affiliation
• Norman Regional Hospital Authority

  dba Norman Regional

  • General Acute Care Hospital
  • Norman, OK
  • NPI 1700882578
  Care Compare affiliation
• Ou Medicine Inc.

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1649794157
  Care Compare affiliation
• Purcell Municipal Hospital

  • General Acute Care Hospital
  • Purcell, OK
  • NPI 1467476911
  Care Compare affiliation
• Purcell Municipal Hospital

  • General Acute Care Hospital
  • Purcell, OK
  • NPI 1851669865
  Care Compare affiliation
• SSM Health Care of Oklahoma Inc

  dba SSM Health Pharmacy

  • Community/Retail Pharmacy
  • Oklahoma City, OK
  • NPI 1649602293

  Hospital

  Care Compare affiliation
• SSM Health Care of Oklahoma, Inc.

  dba SSM Health St. Anthony Hospital - Oklahoma City

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1366545311
  Care Compare affiliation
• St Anthony Shawnee Hospital Inc

  dba St Anthony Shawnee Hospital

  • General Acute Care Hospital
  • Shawnee, OK
  • NPI 1134123193
  Care Compare affiliation

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

{
    "created_epoch": "1212796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1366601015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 N 4TH AVE",
            "address_2": "SUITE 201",
            "city": "PURCELL",
            "state": "OK",
            "postal_code": "730801806",
            "telephone_number": "405-527-5400",
            "fax_number": "405-527-7332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N 4TH AVE",
            "address_2": "SUITE 201",
            "city": "PURCELL",
            "state": "OK",
            "postal_code": "730801806",
            "telephone_number": "405-527-5400",
            "fax_number": "405-527-7332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKELFORD",
        "first_name": "CHARLOTTE",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-07",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylie Rollins
• Zane Rulon, DO
• Saints Medical Group, LLC (SSM Health Medical Group Purcell)
• Ricky Ron Schmidt, MD
• Stephanie R Schmidt, D.D.S.
• Tonja Shandy, P.A.- C
• Larry Sharp, D.O.
• Clarissa Shomo
• Skinner Family Practice LLC
• Tenia Ladonna Skinner, D.O.

• Physician Assistant in Purcell, OK
• Providers in Purcell, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; 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.