NPIMap

Organization Active NPI

Centennial Medical Group North, LLC

Doing business as Centennial Orthopedics

  • Orthopaedic Surgery Physician
  • Roseburg, OR
National Provider Identifier
1922301696
Registry record updated Dec 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
CENTENNIAL MEDICAL GROUP NORTH, LLC
Doing business as
Centennial Orthopedics
Practice address
277 NW Medical Loop
Roseburg, OR 97471-1644
Phone
(541) 677-2131
Fax
(541) 677-2136
NPI assigned
Dec 17, 2010
Last updated
Dec 17, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTENNIAL MEDICAL GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 17, 2010

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

Authorized official

Name
Rahul Agarwal
Title
President
Phone
(541) 677-2494

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

277 NW Medical Loop
Roseburg, OR 97471-1644

Mailing address

2801 NW Mercy Dr
Suite 340
Roseburg, OR 97471-2348
Phone (541) 677-2494

Other names 1

  • Centennial Orthopedics Doing business as

National Provider Directory

National Provider Directory
Part of
Centennial Medical Group Inc

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292544000000",
    "number": "1922301696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 NW MERCY DR",
            "address_2": "SUITE 340",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712348",
            "telephone_number": "541-677-2494",
            "fax_number": "541-677-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 NW MEDICAL LOOP",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711644",
            "telephone_number": "541-677-2131",
            "fax_number": "541-677-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL MEDICAL GROUP NORTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTENNIAL MEDICAL GROUP, INC.",
        "enumeration_date": "2010-12-17",
        "last_updated": "2010-12-17",
        "status": "A",
        "authorized_official_last_name": "AGARWAL",
        "authorized_official_first_name": "RAHUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-677-2494"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centennial Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.