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CENTENNIAL MEDICAL GROUP EAST, LLC
NPI 1235688805
Clinic/Center - Rural Health in Roseburg, OR

Active since September 23, 2016
1937 W HARVARD AVE, ROSEBURG, OR 97471(541) 677-7200(541) 229-3309 Get Directions Write a Review

NPPES record last updated: May 1, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 7, 2019, Dec 22, 2016, Sep 23, 2016 (3 updates tracked since 2016).

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 1235688805) is a healthcare organization registered as a rural health in Roseburg, Oregon and active in the NPI registry since September 2016. The organization lists Kim Tyree, Coo, as its authorized official.

NPPES Registry Identity

NPI1235688805
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameCENTENNIAL MEDICAL GROUP EAST, LLC
Location Address1937 W HARVARD AVERoseburg, OR 97471-2720
Mailing Address2570 Nw Edenbower Blvd Ste 100Roseburg, OR 97471-6214 · (541) 677-7200 · Fax (541) 229-3309
Phone(541) 677-7200
Fax(541) 229-3309
Organization SubpartNo
Authorized OfficialKim TyreeCoo · (541) 229-3332
Enumeration DateSeptember 23, 2016
Last NPPES UpdateMay 1, 20203 updates tracked since enumeration
NPPES CertifiedMay 1, 2020
✔ NPI 1235688805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
License✔ Licensed in OR · 38-3896
Also ListedFamily MedicineTaxonomy 207Q00000X · License MD12182 (OR)
1937 W HARVARD AVE, 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 Providence Health Plan.Insurance ›

Other Providers at the Same Location NPPES 20

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

CENTENNIAL MEDICAL GROUP EAST, LLC
Obstetrics & Gynecology
1937 W HARVARD AVE
ROSEBURG, OR 97471
Douglas County (541) 677-7200
TIMOTHY J POWELL MD
Family Medicine
1937 W HARVARD AVE
ROSEBURG, OR 97471
Douglas County (541) 677-7200
DR. JAIRUS SATHIANATHAN MD
Internal Medicine
1937 W HARVARD AVE
ROSEBURG, OR 97471
Douglas County (541) 677-7200
AMBER R. MILLER D.O.
Pediatrics
1937 W HARVARD AVE
ROSEBURG, OR 97471
Douglas County (541) 677-7200
MARY E POWELL MD
Obstetrics & Gynecology
1937 W HARVARD AVE
ROSEBURG, OR 97471
Douglas County (541) 677-7200
MATTHEW T STARK PA-C.
Physician Assistant (Medical)
1937 W HARVARD AVE
ROSEBURG, OR 97471
Douglas County (541) 677-7200
ELIZABETH C OLER M.D.
Obstetrics & Gynecology
1937 W HARVARD AVE
ROSEBURG, OR 97471
Douglas County (541) 677-7200
STACIE L. HANNA CNM
Advanced Practice Midwife
1937 W HARVARD AVE
ROSEBURG, OR 97471
Douglas County (541) 677-7200

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 1235688805. It was assigned to this organization in the NPPES registry on September 23, 2016.

Where is Centennial Medical Group East, LLC located?

Centennial Medical Group East, LLC is located at 1937 W Harvard Ave, Roseburg, OR 97471. The listed phone number is (541) 677-7200.

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

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

What insurance does Centennial Medical Group East, LLC accept?

Health plans from Providence Health Plan 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 May 1, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.