CENTENNIAL MEDICAL GROUP EAST, LLC – NPI #1134436637
Family Medicine

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.

Health Care Provider Taxonomy Code for Family Medicine

CENTENNIAL MEDICAL GROUP EAST, LLC is a provider located in ROSEBURG, OR. NPPES has assigned the NPI number 1134436637 to CENTENNIAL MEDICAL GROUP EAST, LLC on September 03, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was last updated on Jul 01, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CENTENNIAL MEDICAL GROUP EAST, LLC below.

NPI Profile for
CENTENNIAL MEDICAL GROUP EAST, LLC

NPI Number
1134436637
Enumeration Date

(about 16 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CENTENNIAL MEDICAL GROUP EAST, LLC
Primary location
2570 NW EDENBOWER BLVD
ROSEBURG, OR 97471-6214
Phone: (541) 677-2494 Fax: (541) 677-2294
Mailing address
Same as primary location
Organization Subpart
Yes - CENTENNIAL MEDICAL GROUP EAST, LLC is subpart of another organization.
Authorized Official
KIMBERLY TYREE
COO
Phone: (541) 229-3332
Updated
Certification Date
Jul 01, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)		 OR 71216890
363A00000X
- Physician Assistant		 OR 71216890
207P00000X
- Emergency Medicine		 OR 71216890

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.