Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Evergreen Family Medicine, PC

Q: What type of organization is Evergreen Family Medicine, PC?

Evergreen Family Medicine, PC is registered in NPPES as a Family Medicine Physician (its primary provider taxonomy).

Family Medicine Physician in Roseburg, OR · enumerated 2006 · authorized official Kimberly Tyree, Coo.

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

National Provider Identifier

1568434025

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Registry record

Entity type Organization (Type 2)

Legal business name Evergreen Family Medicine, PC

Other name <Unavail>

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

Phone (541) 677-7200

Fax (541) 229-3309

Enumeration date Feb 7, 2006

Last updated in NPPES Mar 24, 2026

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Primary

261Q00000X Clinic/Center Ambulatory Health Care Facilities Secondary

261QR0200X Radiology Clinic/Center Ambulatory Health Care Facilities Secondary

291U00000X Clinical Medical Laboratory Laboratories Secondary

Authorized official

Name Kimberly Tyree

Title Coo

Phone (541) 229-3332

Other identifiers

Identifier	Type	State	Issuer
J8799-01	Other	OR	GROUP PACIFIC SOURCE
213560	Medicaid	OR	-
610550200	Other	OR	GROUP OWCP
845023000	Other	OR	GROUP BLUE CROSS

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 Evergreen Family Medicine, PC?

Evergreen Family Medicine, PC is registered in NPPES as a Family Medicine Physician (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.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-03-24.