CENTENNIAL MEDICAL GROUP INC NPI 1225207152

NPI Information

  • NPI: 1225207152
  • Provider Name: CENTENNIAL MEDICAL GROUP, INC
  • Classification: Urology - 208800000X
  • Entity Type: Organization
  • Doing Business As: DBA ROSEBURG UROLOGY
  • Address: 2460 NW STEWART PARKWAY,
    SUITE 100
    ROSEBURG, OR
    ZIP 97471
  • Phone: (541) 677-6141

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NPI Details

CENTENNIAL MEDICAL GROUP, INC is an urology in Roseburg, OR. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. CENTENNIAL MEDICAL GROUP, INC NPI is 1225207152. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Dba Roseburg Urology.

The provider's business location address is:

2460 NW STEWART PARKWAY,
SUITE 100
ROSEBURG, OR
ZIP 97471
Phone: (541) 677-6141
Fax: (541) 677-6143

The provider's authorized official is Jason Gray .
The authorized official title is President and has the following contact phone number (541) 677-2494.

The enumeration date for this NPI number is 2/25/2008 and was last updated on 4/4/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208800000XUrology497634-93OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1R0000ZGBFMMEDICARE PINOREGON
2171678MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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