CENTENNIAL MEDICAL GROUP, INC. (NPI# 1871822767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871822767 |
| Entity Type | Organization |
| Organization Name | CENTENNIAL MEDICAL GROUP, INC. |
| Other Organization Name | ROSEBURG ENDOSCOPY |
| Practice Address |
3369 Ne Stephens St Ste A Roseburg OR 97470-1259 |
| Mailing Address |
2801 Nw Mercy Dr Suite 340 Roseburg OR 97471-2348 |
| Practice Telephone | 5415805328 |
| Practice Fax Number | 5416772294 |
| Mailing Telephone | 5416772494 |
| Mailing Fax Number | 5416772294 |
| Enumeration Date | 2009-12-23 |
| Last Update Date | 2010-03-25 |
| Authorized Official Name | ROBERT L. DANNENHOFFER (PRESIDENT) |
| Authorized Official Telephone | 5416772494 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | CENTENNIAL MEDICAL GROUP, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
MD20220 | OR | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Roseburg Endoscopy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144520289 | Centennial Medical Group, Inc. | Internal Medicine | 2460 Nw Stewart Pkwy Ste 103, Roseburg, OR 97471-1516 | 2010-10-22 |
| 1255597936 | Centennial Medical Group, Inc. | Obstetrics & Gynecology | 201 Medical Loop, Suite 170, Roseburg, OR 97471-8821 | 2008-08-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | CENTENNIAL MEDICAL GROUP, INC. | 201 Medical Loop Suite 190, Roseburg, OR 97471 |
| Street Address |
3369 NE STEPHENS ST STE A |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97470-1259 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326547134 | Thoughtwork, LLC | Social Worker | 178 Nw Garden Valley Blvd, Roseburg, OR 97470 | 2018-02-07 |
| 1063932960 | Go Mo, LLC | Durable Medical Equipment & Medical Supplies | 627 Se Jackson St, Roseburg, OR 97470 | 2017-06-21 |
| 1497123335 | Brandi N Hamilton | Counselor | 215 S.e. Jackson, Roseburg, OR 97470 | 2015-09-09 |
| 1285031203 | Aric Fromdahl | Counselor | 215 Se Jackson, Roseburg, OR 97470 | 2014-11-20 |
| 1801292438 | Robin Knebel | Counselor | 215 Se Jackson St., Roseburg, OR 97470 | 2014-11-10 |
| 1700282415 | Samantha Marie Shelley | Counselor | 215 Se Jackson Street, Roseburg, OR 97470 | 2014-11-06 |
| 1043610660 | Cynthia Simmons | Counselor | 150 Ne Kenneth Ford Drive, Roseburg, OR 97470 | 2014-09-02 |
| 1083025431 | Toni Damewood Msn Pmhnp-bc | Nurse Practitioner | 770 Se Kane Street, Roseburg, OR 97470 | 2014-05-19 |
| 1801226196 | Denise Ingeman | Registered Nurse | 1548 South East Pine Street, Roseburg, OR 97470 | 2013-11-22 |
| 1356606909 | Carla Junette Rambel | Massage Therapist | 566 S.e. Jackson, Roseburg, OR 97470 | 2012-07-10 |
| Find all providers in zip 97470 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316122708 | Gerald Engstrom | Internal Medicine | 1813 W Harvard Ave Ste 427, Roseburg, OR 97470-8712 | 2008-01-03 |
| 1841246048 | Lisa A Brandenburger | Internal Medicine | 2564 Nw Edenbower Blvd, Suite 126, Roseburg, OR 97471-8821 | 2006-05-26 |
| 1578524377 | Joseph M Black | Internal Medicine | 2550 Nw Edenbower Blvd, Suite 100, Roseburg, OR 97471-8829 | 2006-03-31 |
| 1609851898 | Gerald Engstrom | Internal Medicine | 2510 Nw Edenbower Blvd Ste 112, Roseburg, OR 97471 | 2005-12-09 |
| 1891003497 | Centennial Medical Group West, LLC | Internal Medicine | 2801 Nw Mercy Dr, Suite 345, Roseburg, OR 97471-2348 | 2010-09-16 |
| 1992031793 | Dempsie B Morrison | Internal Medicine | 2510 Nw Edenbower Blvd Ste 112, Roseburg, OR 97471-8899 | 2009-10-29 |
| 1962637058 | Gi Associates, PC | Internal Medicine | 2560 Nw Medical Park Dr, Roseburg, OR 97471-5510 | 2009-05-19 |
| 1174775951 | Vikas Garg | Internal Medicine | 2510 Nw Edenbower Blvd Ste 112, Roseburg, OR 97471-8899 | 2008-10-13 |
| 1619986981 | Rodolfo B. Lorenzo | Internal Medicine | 913 Nw Garden Valley Blvd, Roseburg, OR 97470-6523 | 2006-08-05 |
| 1629037486 | Sorin Petre | Internal Medicine | 2510 Nw Edenbower Blvd Ste 112, Roseburg, OR 97471-8899 | 2006-03-21 |
| Find all providers in ROSEBURG | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.