Clinic/Center, Rural Health
CENTENNIAL MEDICAL GROUP EAST, LLC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1699103598 · enumerated 2013-10-31 · record updated 2016-11-22. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: KIM TYREE, COO · (541) 229-3332
Other names: EVERGREEN FAMILY MEDICINE SOUTH
Addresses and phones
- Mailing address 2801 NW MERCY DR, SUITE 340, ROSEBURG, OR, 97471-2348 (541) 677-2494 Fax (541) 677-2294 Google Maps Apple Maps OpenStreetMap
- Practice location 145 NE BROADWAY ST, MYRTLE CREEK, OR, 97457-9039 (541) 863-3146 Fax (541) 863-3226 Google Maps Apple Maps OpenStreetMap
Specialties
- Family Medicine 207Q00000X · License 71216890 OR
- Family Medicine 207Q00000X
- Clinic/Center, Rural Health 261QR1300X · Primary
In this directory
Locations and evidence
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Practice location
MYRTLE CREEK, OR, 974579039
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.