Shane Baxter

Primary specialty

DentistTaxonomy code 122300000X

License

D12341 Issued in OR

Practice address

1113 Progress Dr
Medford, OR 97504-5201

Phone

(541) 535-6239

NPI assigned

Jun 3, 2026

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• La Clinica del Valle Family Health Care Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Medford, OR
  • NPI 1891061784
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1780444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1306779111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CHEVY WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 PROGRESS DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045201",
            "telephone_number": "541-535-6239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4940 Hamrick Rd",
            "address_purpose": "LOCATION",
            "city": "Central Point",
            "state": "OR",
            "postal_code": "975023072",
            "country_code": "US",
            "telephone_number": "541-535-6239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAXTER",
        "first_name": "SHANE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-03",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D12341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eden M Baucom
• Olivia Bauer, LAT, ATC
• Tino Frank Bauer, MD
• Stormi Elizabeth Baumann
• Amy Baumgart
• Bayley Putman Counseling LLC
• Erin Tyler Bayne, DPT
• Spencer Bayne
• Jody Beach
• Rylie N. Beach

• Dentist in Medford, OR
• Providers in Medford, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.