CHARLOTTE L SHACKELFORD (PAC) – Physician Assistant, NPI 1366601015
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,797 PHYSICIAN ASSISTANT in OK
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Provider Addresses for CHARLOTTE L SHACKELFORD (PAC)
1401, North 4th Avenue, Purcell, McClain County, Oklahoma, 73080, United States
SUITE 201
PURCELL, OK 730801806
Phone: (405) 527-5400
Fax: (405) 527-7332
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 210 Open Payments records for all available years, with a total value of $3,557.
Total Amount is formed as General ($3,557) + Research ($0) + Ownership ($0) = $3,557.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Novo Nordisk Inc ($469).
Total Amount
$3,557
General + Research + Ownership
Payments
210
Total payment records
General Amount
$3,557
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $469 |
| Lilly USA, LLC | $438 |
| AstraZeneca Pharmaceuticals LP | $437 |
| GlaxoSmithKline, LLC. | $259 |
| PFIZER INC. | $196 |
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: 2010-07-20
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100720001038 | I | Physician Assistant | OK | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 654 | 345 | $0 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 202 | 49 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 141 | 141 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 116 | 59 | $0 |
| 99497 | Advance care planning, first 30 minutes | 101 | 101 | $0 |
Insurance plans in this area (ZIP 73080)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OK | |
| Internal Medicine, Pediatric Medicine | OK | |
| U R O L O G Y | OK | |
| Clinical Social Worker | OK | |
| Physician Assistant | OK | |
| Family Practice | OK | |
| Orthopedic Surgery | OK | |
| Family Practice | OK | |
| Family Practice | OK | |
| General Surgery | OK |
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