MS. JASMINE DONESHA SHACKELFORD (MD) – Family Medicine Physician, NPI 1629606264

MS. JASMINE DONESHA SHACKELFORD (MD) is a healthcare provider. based in Thomaston, Georgia. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 95589 (GA). The NPI Number for MS. JASMINE DONESHA SHACKELFORD (MD) is 1629606264

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
MS. JASMINE DONESHA SHACKELFORD (MD)
NPI
1629606264
Phone
(706) 647-7009
Address
915 W GORDON ST
Enumeration Date
30 March 2020
Last Update Date
29 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7066477009
Graduation Year
2020 (6 years ago)
PAC ID
8729401500
Group Practice PAC ID
3072659242
Professional Enrollment ID
I20230808000060
Address ID
GA302863427TH915XXSTXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

3,102 FAMILY PRACTICE in GA

Provider Addresses for MS. JASMINE DONESHA SHACKELFORD (MD)

  • 915 W GORDON ST

    THOMASTON, GA 302863427

    Phone: (706) 647-7009

    Type: Mailing

  • 104 MADDOX RD

    GRIFFIN, GA 302245282

    Phone: (678) 588-5140

    Type: Mailing

  • EMORY FAMILY MEDICINE

    4500 NORTH SHALLOWFORD ROAD

    ATLANTA, GA 30338

    Phone: (404) 778-6920

    Fax: (404) 778-6901

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 97 Open Payments records for all available years, with a total value of $1,512.

Total Amount is formed as General ($1,512) + Research ($0) + Ownership ($0) = $1,512.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Novo Nordisk Inc ($268).

Total Amount

$1,512

General + Research + Ownership

Payments

97

Total payment records

General Amount

$1,512

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230808000060IFamily PracticeGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes7150$0
36415Insertion of needle into vein for collection of blood sample4033$0
99213Established patient office or other outpatient visit, 20-29 minutes3127$0
View full utilization report →

Insurance plans in this area (ZIP 30286)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3072659242View full group profile
NameSpecialtyState
-GA
Physician AssistantGA
Internal MedicineGA
Nurse PractitionerGA
Physician AssistantGA
Family PracticeGA

Reviews

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Frequently asked questions

What unique ID ties claims to MS. JASMINE DONESHA SHACKELFORD (MD)?
NPI 1629606264 is assigned to MS. JASMINE DONESHA SHACKELFORD (MD) under the national enumeration system.
Is MS. JASMINE DONESHA SHACKELFORD (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize MS. JASMINE DONESHA SHACKELFORD (MD)'s specialty in plain language?
Clinically, the directory lists MS. JASMINE DONESHA SHACKELFORD (MD) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is MS. JASMINE DONESHA SHACKELFORD (MD)'s primary listing?
We display Thomaston, Georgia because that is what the record indicates for MS. JASMINE DONESHA SHACKELFORD (MD).
What if Thomaston, Georgia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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