Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Centennial Medical Group East, LLC

Rural Health Clinic/Center in Roseburg, OR · enumerated 2016 · authorized official Kim Tyree, Coo.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1235688805

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Registry record

Entity type Organization (Type 2)

Legal business name Centennial Medical Group East, LLC

Practice address 1937 W Harvard Ave, Roseburg, OR, 97471

Phone (541) 677-7200

Fax (541) 229-3309

Enumeration date Sep 23, 2016

Last updated in NPPES May 1, 2020

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License MD12182 (OR) Secondary

261QR1300X Rural Health Clinic/Center Ambulatory Health Care Facilities · License 38-3896 (OR) Primary

Authorized official

Name Kim Tyree

Title Coo

Phone (541) 229-3332

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What type of organization is Centennial Medical Group East, LLC?

Centennial Medical Group East, LLC is registered in NPPES as a Rural Health Clinic/Center (its primary provider taxonomy).

What is a Type 2 NPI?

A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-05-01.