Providence Health & Services - Oregon
NPI 1992031595 · Family Medicine Physician · Eagle Point, OR
Provider details
- NPI number
- 1992031595
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Providence Health & Services - Oregon
- Organization subpart
- Yes
- Authorized official
- Donald Anderson, Assistant Secretary Enrollment(425) 358-9786
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Pediatrics Physician208000000X
Allopathic & Osteopathic Physicians
- Child & Adolescent Psychiatry Physician2084P0804X
Allopathic & Osteopathic Physicians
- Geriatric Psychiatry Physician2084P0805X
Allopathic & Osteopathic Physicians
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
Other names (DBA / former)
- Doing business as
- Pmg South Eagle Point
- Doing business as
- Pmg South Eagle Point
- Doing business as
- Providence Medical Group South
Registry dates
- Enumerated
- 2009-11-02
- Last updated
- 2025-11-19
- Certified
- 2025-11-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.