Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Centennial Medical Group Inc

Organization Cardiovascular Disease Physician · NPI 1518103274

Centennial Medical Group Inc is a Cardiovascular Disease Physician in Roseburg, Oregon. Registered with an NPI since 2008.

In the registry since
2008
Specialties on file
8
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

201 NW Medical Loop Ste 190
Roseburg, OR 97471-8835
Phone: (541) 644-4319
Fax: (541) 677-2294
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X
Cardiovascular Disease Physician Taxonomy 207RC0000X
Gastroenterology Physician Taxonomy 207RG0100X
Pulmonary Disease Physician Taxonomy 207RP1001X
Sleep Medicine (Internal Medicine) Physician Taxonomy 207RS0012X
Clinical Pathology/Laboratory Medicine Physician Taxonomy 207ZP0105X
Urology Physician Taxonomy 208800000X
Hospitalist Physician Taxonomy 208M00000X

Record details

NPI number1518103274
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCentennial Medical Group Inc
Authorized official Donna Van Dis — Credentialing Coordinator · (541) 677-4319
NPI enumeratedDecember 31, 2008
Last updated in NPPESNovember 25, 2019
Mailing address201 Nw Medical Loop Ste 190, Roseburg, OR 97471-8835

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