Howard Nelson Croy, P.A.
Individual provider Active NPI Physician Assistant · Brookings, OR
NPI 1295745875 · NPPES record last updated Aug 25, 2015
Key facts
- NPI
- 1295745875
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA153625 (OR)
- Practice address
- 500 5TH St
Brookings, OR 97415-9702 - Phone
- (541) 412-2000
- Fax
- (541) 412-2081
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA153625 | OR | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vepema Medical Group | Emergency Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | PA153625 | OR | |
| Physician Assistant | 363A00000X | PA153625 | OR | Yes |
Addresses
Primary practice location
500 5TH St
Brookings, OR 97415-9702
Mailing address
94220 4TH St
Gold Beach, OR 97444-7756
Phone (541) 247-3000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 93-0937095 | Other | OR | CURRY HEALTH DISTRICT TAX I.D. |
| 1487696985 | Other | OR | CURRY HEALTH DISTRICT NPI |
| 500605180 | Medicaid | OR | |
| PA12369 | Medicaid | CA |
Other providers in Brookings, OR
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- Teresa Ione Costa
- County of Curry Brookings Harbor School District 17C
- Kellie Marie Creaser
- Curry Health District
- Curry Health District
- Dane E. Smith DDS PC
- Ellen Dar
- Olivia Ann Deitering
All providers in Brookings, OR · Physician Assistant in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.