Jonathan Brad Egbert, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14271352-1205 Issued in UT

Practice address

1055 N 500 W
Provo, UT 84604-3305

Phone

(801) 354-8225

Fax

(801) 418-0941

NPI assigned

Mar 9, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Jonathan Brad Egbert Former name

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

Emergency Medicine

Education

Other, 2015

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jonathan.egbert.1@1334.direct.athenahealth.com

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

  Family Medicine, OR

  Medicare reassignment Care Compare group NPD
• Centennial Medical Group East, LLC

  • Family Medicine Physician
  • Sutherlin, OR
  • NPI 1164124111

  Family Medicine

  Care Compare group NPD
• Centennial Medical Group East, LLC

  • Rural Health Clinic/Center
  • Roseburg, OR
  • NPI 1235688805
  Care Compare group
• Centennial Medical Group East, LLC

  • Rural Health Clinic/Center
  • Myrtle Creek, OR
  • NPI 1699103598
  Care Compare group
• Centennial Medical Group East, LLC

  • Rural Health Clinic/Center
  • Roseburg, OR
  • NPI 1821366071
  Care Compare group
• Evergreen Family Medicine, PC

  • Family Medicine Physician
  • Roseburg, OR
  • NPI 1417929050
  Care Compare group
• University of Wyoming

  • Federally Qualified Health Center (FQHC)
  • Cheyenne, WY
  • NPI 1770681439

  Family Medicine

  NPD (past)

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

• Commonspirit Oregon

  • General Acute Care Hospital
  • Roseburg, OR
  • NPI 1477590198

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1972801397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "ATTN CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGBERT",
        "first_name": "JONATHAN",
        "middle_name": "BRAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-09",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "14271352-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JONATHAN",
            "last_name": "EGBERT",
            "middle_name": "BRAD",
            "prefix": "MR.",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julie Edwards, FNP-C
• Kandis May Edwards
• Kate Aryn Edwards, CSW
• Porter Darin Edwards, DO
• Rebecca Davis Edwards, APRN STUDENT
• William Joseph Egbert
• Braquel Egginton
• Justine Cadayong Eggleston
• Emily Ruth Eggli, COTA/L
• Cassidy Eiers, ATC, LAT

• All providers in Provo, UT
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; 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.

Verify at the official NPI Registry.