Shane Smedley, QMHA-R, CRM, PSS-AD

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

108144 Issued in OR

Practice address

361 Yewwood Dr
Shady Cove, OR 97539-9794

Phone

(458) 204-8226

NPI assigned

Apr 10, 2023

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1710672449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 YEWWOOD DR",
            "city": "SHADY COVE",
            "state": "OR",
            "postal_code": "975399794",
            "telephone_number": "458-204-8226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 YEWWOOD DR",
            "city": "SHADY COVE",
            "state": "OR",
            "postal_code": "975399794",
            "telephone_number": "458-204-8226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMEDLEY",
        "first_name": "SHANE",
        "name_prefix": "Mr.",
        "credential": "QMHA-R, CRM, PSS-AD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-10",
        "last_updated": "2025-09-11",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "108144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rogue Community Health
• Shady Cove Chiropractic and Massage, LLC
• Shady Cove Chiropractic, LLC
• Shady Cove Family Dentistry
• Sisters of Providence in Oregon (PMG South Shady Cove)
• Ann Marie Sprague, DPT
• Sarah Joyce Spriggs, LMT, BCTMB
• David Lee Thompson, PTA
• Upper Rogue Physical Therapy
• Ginger Marie Whitt X

• Peer Specialist in Shady Cove, OR
• Providers in Shady Cove, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.