EVERGREEN FAMILY MEDICINE, PC – NPI #1417929050
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.

EVERGREEN FAMILY MEDICINE, PC is a provider located in ROSEBURG, OR. NPPES has assigned the NPI number 1417929050 to EVERGREEN FAMILY MEDICINE, PC on February 07, 2006. 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 22, 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 EVERGREEN FAMILY MEDICINE, PC below.

NPI Profile for
EVERGREEN FAMILY MEDICINE, PC

NPI Number
1417929050
Enumeration Date

(more than 20 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
EVERGREEN FAMILY MEDICINE, PC
Primary location
2570 NW EDENBOWER BLVD STE 100
ROSEBURG, OR 97471-6214
Phone: (541) 229-3301 Fax: (541) 677-7462
1 Other location(s):
1937 W Harvard Ave
Roseburg, OR 97471-2720
Phone: (541) 677-7200
Mailing address
2570 NW EDENBOWER BLVD
STE 100
ROSEBURG, OR 97470-6214
Phone: (541) 229-3301 Fax: (541) 677-7462
Organization Subpart
No
Authorized Official
KIMBERLY TYREE
COO
Phone: (541) 229-3332
Updated
Certification Date
Jul 22, 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.

Identifiers

Identifiers for EVERGREEN FAMILY MEDICINE, PC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherGROUP RAILROADORCN5472
medicaidOR000116
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)
207P00000X
- Emergency Medicine

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.