DR. JAMES RYAN SHACKELFORD MD
NPI 1639217359
Psychiatry & Neurology - Psychiatry in Boise, ID

Q: What is James Shackelford's NPI number?

The NPI number for James Shackelford is 1639217359. It was assigned to this individual provider in the NPPES registry on February 2, 2007.

Q: What is James Shackelford's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: Is James Shackelford enrolled in Medicare?

No. James Shackelford has opted out of Medicare through October 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for James Shackelford was last updated on December 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 02, 2007Opted out of Medicare · through Oct 1, 2027

777 N RAYMOND ST, BOISE, ID 83704(208) 514-2500(208) 375-2217 Get Directions Write a Review

NPPES record last updated: December 20, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. James Ryan Shackelford Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JAMES RYAN SHACKELFORD MD (NPI 1639217359) is an individual psychiatry provider in Boise, Idaho, licensed in Idaho (M-13301) and active in the NPI registry since February 2007. He has opted out of Medicare through October 1, 2027 and maintains a secondary practice location in Nampa.

NPPES Registry Identity

NPI1639217359

Entity TypeIndividualMale

Primary Taxonomy2084P0800X

Provider Legal NameDR. JAMES RYAN SHACKELFORDCredential: MD

Location Address777 N RAYMOND STBoise, ID 83704

Mailing Address1525 S Owyhee StBoise, ID 83705-6014 · (208) 297-3698 · Fax (208) 561-8051

Phone(208) 514-2500

Fax(208) 375-2217

Sole ProprietorNo

Enumeration DateFebruary 2, 2007

Last NPPES UpdateDecember 20, 2023

NPPES CertifiedDecember 20, 2023

✔ NPI 1639217359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

Licenses✔ Licensed in ID · M-13301✔ Licensed in CA · NONE

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

Also ListedFamily MedicineTaxonomy 207Q00000X · License NONE (CA)

777 N RAYMOND ST, Boise, ID 83704

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Secondary Practice Location 1

Location 1211 16th Ave NNampa, ID 83687-4058 · Phone (208) 467-4431

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. James Ryan Shackelford Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2023 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2023

Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TRACY ADAMS DO

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