Evergreen Family Medicine, PC
NPI 1417929050ActiveOrganization· Family Medicine· Roseburg, OR
Family Medicine in Roseburg, Oregon, registered in NPPES in February 2006. The authorized official on file is Kimberly Tyree, Coo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1417929050 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 7, 2006 |
| Last updated in NPPES | Jul 22, 2025 |
| Certified by provider | Jul 22, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Emergency Medicine | 207P00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (OR) |
|---|
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