Individual provider Active NPI

Samantha Birenbaum Griffin, FNP

  • Family Nurse Practitioner
  • Roseburg, OR
National Provider Identifier
1952852568
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201608220NP-PP Issued in OR
Practice address
277 NW Medical Loop
Roseburg, OR 97471-1644
Phone
(541) 743-9003
Fax
(541) 284-0520
NPI assigned
Oct 18, 2016
Last updated
Oct 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201608220NP-PP OR Primary

Addresses

Primary practice location

277 NW Medical Loop
Roseburg, OR 97471-1644

Mailing address

217 Division Ave
Eugene, OR 97404-5429
Phone (541) 743-9003

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161130001625 OR Practitioner - Nurse Practitioner 6103106596 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centennial Medical Group IncGroup PAC ID 6103982962, 60 clinicians

Practice addresses (Care Compare)

201 NW Medical Loop
Suite 190
Roseburg, OR 97471-8835

2510 NW Edenbower Blvd
Suite 112
Roseburg, OR 97471-8899
Phone (541) 541-4646

2700 NW Stewart Pkwy
Roseburg, OR 97471-1281
Phone (541) 677-2452

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icco LLC CurrentSince Oct 25, 2021 Accepting new patients
Pacific Sports and Interventional Spine, LLC-P CurrentSince Sep 19, 2023 Accepting new patients
Icco, LLC Current Accepting new patients
Centennial Medical Group Inc. CurrentSince Jul 20, 2024 Accepting new patients
Icco LLC CurrentSince Oct 25, 2021 Accepting new patients
Pacific Sports and Interventional Spine, LLC CurrentSince Sep 19, 2023 Accepting new patients

Locations

1711 Willamette St
Ste 302
Eugene, OR 97401
Phone (541) 357-4536

217 Division Ave
Eugene, OR 97404
Phone (541) 686-3791

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

277 NW Medical Loop
Roseburg, OR 97471
Phone (541) 677-2131

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1952852568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 DIVISION AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974045429",
            "telephone_number": "541-743-9003",
            "fax_number": "541-284-0520"
        },
        {
            "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": "541-743-9003",
            "fax_number": "541-284-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "SAMANTHA",
        "middle_name": "BIRENBAUM",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-18",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201608220NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

Verify at the official NPI Registry.