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EVERGREEN FAMILY MEDICINE
NPI 1821366071
Clinic/Center - Rural Health in Roseburg, OR

Active since December 02, 2011
2570 NW EDENBOWER BLVD, ROSEBURG, OR 97471(541) 677-7200(541) 229-3309 Get Directions Write a Review

NPPES record last updated: February 6, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Evergreen Family Medicine NPPES

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

EVERGREEN FAMILY MEDICINE (NPI 1821366071) is a healthcare organization registered as a rural health in Roseburg, Oregon and active in the NPI registry since December 2011. The organization lists Jason Gray, President, as its authorized official.

NPPES Registry Identity

NPI1821366071
Entity TypeOrganization
Primary Taxonomy261QR1300X
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) 229-3309
Phone(541) 677-7200
Fax(541) 229-3309
Organization SubpartYesParent: Centennial Medical Group, Inc.
Authorized OfficialJason GrayPresident · (541) 677-2494
Enumeration DateDecember 2, 2011
Last NPPES UpdateFebruary 6, 2013
✔ NPI 1821366071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
2570 NW EDENBOWER BLVD, Roseburg, OR 97471
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Other Names 1

Doing Business AsEvergreen Family Medicine

Other Identifiers 1

Medicare OSCAR/certification383880OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..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
CENTENNIAL MEDICAL GROUP EAST, LLC
Family Medicine
2570 NW EDENBOWER BLVD
ROSEBURG, OR 97471
Douglas County (541) 677-2494
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

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 1821366071. It was assigned to this organization in the NPPES registry on December 2, 2011. The provider is doing business as Evergreen Family Medicine.

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) 677-7200.

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 Moda Health Plan, Inc. 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 February 6, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.