John L Powell, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD19972 Issued in OR

Practice address

2570 NW Edenbower Blvd
Suite 100
Roseburg, OR 97470-6220

Phone

(541) 677-7200

Fax

(541) 229-3364

NPI assigned

Feb 9, 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, 1993

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.powelluc.1@1334.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/1334/brand/1/csg/42/fhir/r4

All facility ownership & control disclosures 1

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

Owned or controlled facilities with NPI records 1

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

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 (past)
• 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

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

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260489600000",
    "number": "1811960883",
    "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": "541-229-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 NW EDENBOWER BLVD",
            "address_2": "SUITE 100",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974706220",
            "telephone_number": "541-677-7200",
            "fax_number": "541-229-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "JOHN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2009-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD19972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND BLUE CROSS",
            "identifier": "000188013",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150778",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND PACSOURCE",
            "identifier": "J406411",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND RAILROAD",
            "identifier": "080120962",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriel Potter
• Tammie L Potter
• Rebecca Potuzak, B.S.
• William C. Poulter, CADC II-ACCBO (OREGO
• Frances Anne Powell, LCSW
• Keryssa Powell
• Mary E Powell, MD
• Timothy J Powell, MD
• Stacy M. Powers, CHW
• Katrina J Powley

• 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 Dec 11, 2009; 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.