Evergreen Family Medicine, PC
NPI 1417929050 · Family Medicine Physician · Roseburg, OR
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Evergreen Family Medicine, PC is a Family Medicine Physician organization in Roseburg, OR (NPI 1417929050).
Provider details
- NPI number
- 1417929050
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kimberly Tyree, Coo(541) 229-3332
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Emergency Medicine Physician207P00000X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 1937 W Harvard AveRoseburg, OR 97471-2720Phone: (541) 677-7200
Registry dates
- Enumerated
- 2006-02-07
- Last updated
- 2025-07-22
- Certified
- 2025-07-22
Frequently asked questions
- What is Evergreen Family Medicine, PC's NPI number?
- Evergreen Family Medicine, PC's National Provider Identifier (NPI) is 1417929050, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Evergreen Family Medicine, PC?
- Evergreen Family Medicine, PC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Evergreen Family Medicine, PC located?
- Evergreen Family Medicine, PC's practice location on file with NPPES is 2570 Nw Edenbower Blvd Ste 100, Roseburg, OR 97471-6214.
- What is Evergreen Family Medicine, PC's phone number?
- The practice phone number listed in the NPPES registry for Evergreen Family Medicine, PC is (541) 229-3301.
- Does Evergreen Family Medicine, PC accept Medicare?
- Evergreen Family Medicine, PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Evergreen Family Medicine, PC?
- The authorized official listed on Evergreen Family Medicine, PC's NPPES record is Kimberly Tyree, Coo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Evergreen Family Medicine, PC's NPI active?
- Yes — Evergreen Family Medicine, PC's NPI (1417929050) is active in the NPPES registry as of the last update on 2025-07-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.