Active NPI
Natalie Moffett, MD
- Family Medicine Physician
- Sutherlin, OR
National Provider Identifier
1629508957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD198407
- Practice address
- 249 Dakota St
Sutherlin, OR 97479-9908 - Phone
- (541) 677-7200
- Fax
- (541) 229-3309
- NPI assigned
- Jun 19, 2017
- Last updated
- Aug 9, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD198407 | OR | Primary |
Addresses
Primary practice location
249 Dakota St
Sutherlin, OR 97479-9908
Mailing address
2570 NW Edenbower Blvd Ste 100
Roseburg, OR 97471-6214
Phone (541) 677-7200
Other practice location 1
2570 NW Edenbower Blvd Ste 100
Roseburg, OR 97471-6214
Phone (541) 677-7200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500778786 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- West Virginia University School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2570 NW Edenbower Blvd
Roseburg, OR 97471-6214
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centennial Medical Group East, LLC | Family Medicine | Current | Accepting new patients |
| Centennial Medical Group East, LLC | Family Medicine | Current | Accepting new patients |
Locations
2570 NW Edenbower Blvd
Ste 100
Roseburg, OR 97471
Phone (541) 677-7200
249 Dakota St
Sutherlin, OR 97479
Phone (541) 529-4711
Interoperability endpoints
- natalie.moffett.1@1334.direct.athenahealth.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Roseburg, OR
- NPI 1134436637
-
- Family Medicine Physician
- Roseburg, OR
- NPI 1417929050
-
dba Evergreen Family Medicine North
- Family Medicine Physician
- Sutherlin, OR
- NPI 1164124111
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Amedisys Hospice Care
- Community Based Hospice Care Agency
- Roseburg, OR
- NPI 1083807101
-
dba Amedisys Home Health Care
- Home Health Agency
- Roseburg, OR
- NPI 1093908725
-
dba CHI Mercy Medical Center
- General Acute Care Hospital
- Roseburg, OR
- NPI 1477590198
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691539200000",
"number": "1629508957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2570 NW EDENBOWER BLVD STE 100",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974716214",
"telephone_number": "541-677-7200",
"fax_number": "541-229-3309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "249 DAKOTA ST",
"city": "SUTHERLIN",
"state": "OR",
"postal_code": "974799908",
"telephone_number": "541-677-7200",
"fax_number": "541-229-3309"
}
],
"practiceLocations": [
{
"address_1": "2570 NW Edenbower Blvd Ste 100",
"address_purpose": "LOCATION",
"city": "Roseburg",
"state": "OR",
"postal_code": "974716214",
"country_code": "US",
"telephone_number": "541-677-7200",
"fax_number": "541-229-3309",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOFFETT",
"first_name": "NATALIE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-19",
"last_updated": "2023-08-09",
"certification_date": "2020-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD198407",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500778786",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sutherlin, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.