DR R C SHACKELFORD OPTOMETRIST (NPI# 1306008719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306008719 |
| Entity Type | Organization |
| Organization Name | DR R C SHACKELFORD OPTOMETRIST |
| Other Organization Name | SHACKELFORD FAMILY EYECARE |
| Practice Address |
2350 Mount Pleasant Rd Hernando MS 38632-1909 |
| Mailing Address |
8815 Millbranch Rd Southaven MS 38671-2312 |
| Practice Telephone | 6624294448 |
| Practice Fax Number | 6624295975 |
| Mailing Telephone | 6623934161 |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2019-06-12 |
| Authorized Official Name | DR. RAYMOND CALVIN SHACKELFORD (OWNER) |
| Authorized Official Telephone | 6624294448 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00087049 | 05 |
| Other Name | Type Code |
|---|---|
| SHACKELFORD FAMILY EYECARE | Doing Business As Name - Organization |
| Street Address |
2350 MOUNT PLEASANT RD |
| City | HERNANDO |
| State | MS |
| Zip Code | 38632-1909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255954863 | Vrf Eye Specialty Group, Plc | Ophthalmology | 2350 Mount Pleasant Rd, Hernando, MS 38632-1909 | 2020-05-19 |
| 1861916991 | Emily Clare Ridge | Optometrist | 2350 Mount Pleasant Rd, Hernando, MS 38632-1909 | 2017-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275042335 | Dominic Lashay Freeman | Case Management | 2744 Hwy 51 South, Hernando, MS 38632 | 2017-09-21 |
| 1851814875 | Staci Lea Hudson | Nurse Practitioner | 2705 Hwy 51 South, Hernando, MS 38632 | 2017-07-21 |
| 1629425517 | Jamieka Harris | Counselor | 2705 Hwy 51 S, Hernando, MS 38632 | 2016-05-20 |
| 1215302476 | Elizabeth Claire Corban | Counselor | 2725 Highway 51 S., Hernando, MS 38632 | 2015-12-14 |
| 1669850004 | Jcc, LLC | Dentist | 1150 Monteith Avenue, Suite 102, Hernando, MS 38632 | 2015-05-18 |
| 1053701995 | Leigh Houston | Registered Nurse | 3104 Stonehenge Dr, Hernando, MS 38632 | 2015-01-30 |
| 1871831552 | Hernando Dental Group Incorporated | Dentist | 2264 Mcingvale Rd., Hernando, MS 38632 | 2013-01-30 |
| 1255677001 | Midsouth Medical Specialties, LLC | Pharmacy | 2260 Highway 515 South, Hernando, MS 38632 | 2012-12-26 |
| 1447506514 | Surgical First Assist, LLC | Specialist/Technologist, Other | 8921 Black Panther Cove, Herenando, MS 38632 | 2012-07-26 |
| 1629348396 | Stacy Riddle-mattox | Counselor | 2725 Highway 51 South, Hernando, MS 38632 | 2012-01-11 |
| Find all providers in zip 38632 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558499640 | Raymond Calvin Shackelford | Optometrist | 2350 Mt Pleasant Rd, Hernando, MS 38632-1909 | 2007-03-01 |
| 1467542241 | John D Carlson | Optometrist | 2170 Highway 51 S Ste 6, Hernando, MS 38632-1108 | 2006-10-13 |
| 1679689855 | Michael D Honeycutt | Optometrist | 165 W South St, Hernando, MS 38632-2265 | 2006-08-21 |
| 1881655645 | Claudia L Chavez | Optometrist | 2629 N Forest Ridge Blvd, Hernando, FL 34442-5123 | 2006-03-31 |
| 1861916991 | Emily Clare Ridge | Optometrist | 2350 Mount Pleasant Rd, Hernando, MS 38632-1909 | 2017-07-31 |
| 1376900951 | Myeyedr. Optometry of Florida, LLC | Optometrist | 2629 N Forest Ridge Blvd, Hernando, FL 34442-5123 | 2016-01-27 |
| 1972647519 | Kenya Henderson | Optometrist | 2600 Mcingvale Rd, Hernando, MS 38632-8658 | 2007-02-16 |
| 1306931597 | Henderson Vision Center | Optometrist | 2600 Mcingvale Rd, Hernando, MS 38632-8658 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386252609 | Primary Eyecare South LLC | Optometrist | 1217 S Frontage Rd Ste E, Meridian, MS 39301-6124 | 2020-07-22 |
| 1497371306 | Premier Eye Care, Pllc | Optometrist | 940 W Commerce St, Aberdeen, MS 39730-2337 | 2020-06-17 |
| 1902430937 | Dr Elizabeth M Darby Optometrist Pllc | Optometrist | 504 Easel St, Taylor, MS 38673 | 2020-02-28 |
| 1699320929 | Channing F Bucklew | Optometrist | 3090 N Church Ave, Louisville, MS 39339-6349 | 2019-08-05 |
| 1083266498 | Royce Vandiver Miles Jr. | Optometrist | 521 Deerfield Dr, Forest, MS 39074-6006 | 2019-07-15 |
| 1952965022 | Byhalia Vision Center LLC | Optometrist | 8250 Hwy 178 West, Byhalia, MS 38611-6776 | 2019-04-24 |
| 1770044497 | Tri County Eye Clinic, Pllc | Optometrist | 3430 Bienville Boulevard, Ocean Springs, MS 39564-5732 | 2019-03-26 |
| 1508351628 | Hilarie Nixon Holt | Optometrist | 301 Northlake Ave Ste 101, Ridgeland, MS 39157-1720 | 2018-06-30 |
| 1770097883 | Keeping Focus LLC. | Optometrist | 4223 I-20 Frontage Rd Apt J18, Vicksburg, MS 39183-3533 | 2017-11-28 |
| 1386168730 | Nettie Hines | Optometrist | 1006 Treetops Blvd Ste 105, Flowood, MS 39232-7645 | 2017-07-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.