Individual provider Active NPI

Shayne Croft

  • Community Health Registered Nurse
  • Gresham, OR
National Provider Identifier
1407747595
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
10000174 Issued in OR
Practice address
3008 NE 25TH CT
Gresham, OR 97030-3394
Phone
(360) 751-1510
NPI assigned
Jul 15, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 10000174 OR Primary

Addresses

Primary practice location

3008 NE 25TH CT
Gresham, OR 97030-3394

Mailing address

3008 NE 25TH CT
Gresham, OR 97030-3394
Phone (360) 751-1510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10000174ORMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1752537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1407747595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3008 NE 25TH CT",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303394",
            "telephone_number": "360-751-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3008 NE 25TH CT",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303394",
            "telephone_number": "360-751-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROFT",
        "first_name": "SHAYNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "OR",
            "license": "10000174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.