Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum Organization subpart

Centennial Medical Group Inc.

Q: What type of organization is Centennial Medical Group Inc.?

Centennial Medical Group Inc. is registered in NPPES as a Surgery Physician (its primary provider taxonomy).

Surgery Physician in Roseburg, OR · enumerated 2008 · authorized official Donna Van Dis, Credentialing Coordinator.

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

National Provider Identifier

1518103274

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Registry record

Entity type Organization (Type 2)

Legal business name Centennial Medical Group Inc.

Parent organization Centennial Medical Group Inc.

Practice address 201 Nw Medical Loop Ste 190, Roseburg, OR, 97471

Phone (541) 644-4319

Fax (541) 677-2294

Enumeration date Dec 31, 2008

Last updated in NPPES Nov 25, 2019

Taxonomy & classification

207RC0000X Cardiovascular Disease Physician Allopathic & Osteopathic Physicians Secondary

207RG0100X Gastroenterology Physician Allopathic & Osteopathic Physicians Secondary

207RP1001X Pulmonary Disease Physician Allopathic & Osteopathic Physicians Secondary

207RS0012X Sleep Medicine (Internal Medicine) Physician Allopathic & Osteopathic Physicians Secondary

207ZP0105X Clinical Pathology/Laboratory Medicine Physician Allopathic & Osteopathic Physicians Secondary

208600000X Surgery Physician Allopathic & Osteopathic Physicians Primary

208800000X Urology Physician Allopathic & Osteopathic Physicians Secondary

208M00000X Hospitalist Physician Allopathic & Osteopathic Physicians Secondary

Authorized official

Name Donna Van Dis

Title Credentialing Coordinator

Phone (541) 677-4319

Other identifiers

Identifier	Type	State	Issuer
500601997	Medicaid	OR	-

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 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.

What type of organization is Centennial Medical Group Inc.?

Centennial Medical Group Inc. is registered in NPPES as a Surgery Physician (its primary provider taxonomy).

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2019-11-25.