Raymond Calvin Shackelford, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD589-94300 Issued in MS

Practice address

2350 Mt Pleasant Rd
Hernando, MS 38632-1909

Phone

(662) 429-4448

Fax

(662) 429-5975

NPI assigned

Mar 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.7 of 100Reported as group

Quality

86.03

Improvement activities

40

Cost

74.63

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: drshackelford@esg.emadirect.md

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.

• Dr R C Shackelford Optometrist

  • Optometrist
  • Hernando, MS
  • NPI 1306008719
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1558499640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 MT PLEASANT RD",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386321909",
            "telephone_number": "662-429-4448",
            "fax_number": "662-429-5975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKELFORD",
        "first_name": "RAYMOND",
        "middle_name": "CALVIN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "OD589-94300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00087049",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie L Scarpace, P.T.
• Jeremy Schrimsher, MA
• Susan Scott, F.N.P.
• Kalyn Seale
• Robert Burdette Seymour, DDS
• Debra Shelton, LPC, MHSP
• Leanna Nikole Simmons
• Stephanie Simmons
• Bonnie Durrett Sisk, HAS
• Elizabeth D Smith, PTA

• 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; 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.