CENTENNIAL MEDICAL GROUP EAST, LLC
NPI 1134436637
Family Medicine in Roseburg, OR

Q: What is Centennial Medical Group East, LLC's NPI number?

The NPI number for Centennial Medical Group East, LLC is 1134436637. It was assigned to this organization in the NPPES registry on September 3, 2010.

Q: What is Centennial Medical Group East, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since September 03, 2010

2570 NW EDENBOWER BLVD, ROSEBURG, OR 97471(541) 677-2494(541) 677-2294 Get Directions Write a Review

NPPES record last updated: July 1, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Centennial Medical Group East, Llc NPPES

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

CENTENNIAL MEDICAL GROUP EAST, LLC (NPI 1134436637) is a healthcare organization registered as a family medicine in Roseburg, Oregon and active in the NPI registry since September 2010. The organization lists Kimberly Tyree, Coo, as its authorized official.

NPPES Registry Identity

NPI1134436637

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameCENTENNIAL MEDICAL GROUP EAST, LLC

Location Address2570 NW EDENBOWER BLVDRoseburg, OR 97471-6214

Mailing Address2570 Nw Edenbower BlvdRoseburg, OR 97471-6214 · (541) 677-7200 · Fax (541) 677-7200

Phone(541) 677-2494

Fax(541) 677-2294

Organization SubpartYesParent: Centennial Medical Group, Inc.

Authorized OfficialKimberly TyreeCoo · (541) 229-3332

Enumeration DateSeptember 3, 2010

Last NPPES UpdateJuly 1, 2025

NPPES CertifiedJuly 1, 2025

✔ NPI 1134436637 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in OR · 71216890

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedEmergency MedicineTaxonomy 207P00000X · License 71216890 (OR)

Also ListedPhysician AssistantTaxonomy 363A00000X · License 71216890 (OR)

2570 NW EDENBOWER BLVD, Roseburg, OR 97471

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Oregon.Insurance ›

Other Providers at the Same Location NPPES 12

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

PAUL J FIEBER P.A.

Physician Assistant

2570 NW EDENBOWER BLVD, SUITE 100
ROSEBURG, OR 97471

Douglas County (541) 677-7200

ELISE ANNE LIPPINCOTT MD

Pediatrics

2570 NW EDENBOWER BLVD
ROSEBURG, OR 97471

Douglas County (541) 677-7200

MS. CHRISTINE LAUREN HAYES

Counselor (Mental Health)

2570 NW EDENBOWER BLVD
ROSEBURG, OR 97471

Douglas County (541) 677-7200

CHARLES A MUSGRAVE PA-C

Physician Assistant

2570 NW EDENBOWER BLVD, SUITE 100
ROSEBURG, OR 97471

Douglas County (541) 957-1111

CHENELLE D MCCASKILL PA

Physician Assistant (Surgical)

2570 NW EDENBOWER BLVD, STE 100
ROSEBURG, OR 97471

Douglas County (541) 957-1111

ISABEL GABRIELA VERDUZCO QMHA-R

Case Manager/Care Coordinator

2570 NW EDENBOWER BLVD
ROSEBURG, OR 97471

Douglas County (541) 677-7200

JENNIFER T JARASA M.D.

Family Medicine

2570 NW EDENBOWER BLVD, SUITE 100
ROSEBURG, OR 97471

Douglas County (541) 677-7200

HEATHER NICOLE HERNANDEZ PA

Physician Assistant

2570 NW EDENBOWER BLVD
ROSEBURG, OR 97471

Douglas County (541) 733-5403

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Centennial Medical Group East, LLC's NPI number?

The NPI number for Centennial Medical Group East, LLC is 1134436637. It was assigned to this organization in the NPPES registry on September 3, 2010.

Where is Centennial Medical Group East, LLC located?

Centennial Medical Group East, LLC is located at 2570 NW Edenbower Blvd, Roseburg, OR 97471. The listed phone number is (541) 677-2494.

What is Centennial Medical Group East, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

What insurance does Centennial Medical Group East, LLC accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Oregon list Centennial Medical Group East, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Centennial Medical Group East, LLC was last updated on July 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.