Timothy J Powell, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD12182 Issued in OR

Practice address

1937 W Harvard Ave
Roseburg, OR 97471-2720

Phone

(541) 677-7200

Fax

(541) 229-3309

NPI assigned

Feb 8, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Oregon Health Sciences University School of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centennial Medical Group East LLCGroup PAC ID 9234397878, 63 clinicians

Evergreen Family Medicine PCGroup PAC ID 3870485139, 55 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center Hospital, Roseburg, OR, CCN 380027
• Umpqua Valley Nursing & Rehabilitation Center Nursing home, Roseburg, OR, CCN 385143
• Rose Haven Nursing Center Nursing home, Roseburg, OR, CCN 385151

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1334/brand/1/csg/42/fhir/r4

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Centennial Medical Group East, LLC

  • Family Medicine Physician
  • Sutherlin, OR
  • NPI 1164124111

  5% Or Greater Direct Ownership Interest, Corporate Officer, General Partnership Interest

  CMS ownership
• Centennial Medical Group East, LLC

  • Rural Health Clinic/Center
  • Roseburg, OR
  • NPI 1235688805

  Corporate Officer, Operational/Managerial Control

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Centennial Medical Group East, LLC

  • Family Medicine Physician
  • Roseburg, OR
  • NPI 1134436637
  Medicare reassignment Care Compare group NPD
• Evergreen Family Medicine, PC

  • Family Medicine Physician
  • Roseburg, OR
  • NPI 1417929050
  Care Compare group NPD
• Centennial Medical Group East, LLC

  • Family Medicine Physician
  • Sutherlin, OR
  • NPI 1164124111
  NPD
• Centennial Medical Group East, LLC

  • Rural Health Clinic/Center
  • Myrtle Creek, OR
  • NPI 1699103598

  Family Medicine

  NPD
• Evergreen Family Medicine, PC

  • Family Medicine Physician
  • Roseburg, OR
  • NPI 1568434025
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Commonspirit Oregon

  • General Acute Care Hospital
  • Roseburg, OR
  • NPI 1477590198
  Care Compare affiliation
• Sweet Briar Nursing Center LLC

  • Skilled Nursing Facility
  • Roseburg, OR
  • NPI 1467160804

  Nursing home

  Care Compare affiliation
• Umpqua River Nursing & Rehab LLC

  • Skilled Nursing Facility
  • Roseburg, OR
  • NPI 1376251710

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1689647844",
    "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": "1937 W HARVARD AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712720",
            "telephone_number": "541-677-7200",
            "fax_number": "541-229-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD12182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND PACSOURCE",
            "identifier": "J406423",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND RAILROAD",
            "identifier": "080120961",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065847",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND BLUE CROSS",
            "identifier": "000188005",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William C. Poulter, CADC II-ACCBO (OREGO
• Frances Anne Powell, LCSW
• John L Powell, MD
• Keryssa Powell
• Mary E Powell, MD
• Stacy M. Powers, CHW
• Katrina J Powley
• Prana Counseling LLC
• Pratt Therapeutic Solutions LLC
• Julie Pressel

• Family Medicine Physician in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.

Verify at the official NPI Registry.