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WHITE OAK MEDICAL CLINIC LLC
NPI 1043003114
Family Medicine in Roseburg, OR

Active since May 22, 2025CLIA Certified · 2 labs
340 NW MEDICAL LOOP, ROSEBURG, OR 97471(541) 464-5907 Get Directions Write a Review

NPPES record last updated: May 22, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About White Oak Medical Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WHITE OAK MEDICAL CLINIC LLC (NPI 1043003114), doing business as White Oak Medical Center, is a healthcare organization registered as a family medicine in Roseburg, Oregon and active in the NPI registry since May 2025. The organization holds 2 active CLIA laboratory certificates and lists Diane Bolduc, President, as its authorized official.

NPPES Registry Identity

NPI1043003114
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameWHITE OAK MEDICAL CLINIC LLC
Location Address340 NW MEDICAL LOOPRoseburg, OR 97471-1645
Mailing Address340 Nw Medical LoopRoseburg, OR 97471-1645 · (541) 464-5907
Phone(541) 464-5907
Organization SubpartNo
Authorized OfficialDiane BolducPresident · (541) 464-5907
Enumeration DateMay 22, 2025
NPPES CertifiedMay 22, 2025
✔ NPI 1043003114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X
340 NW MEDICAL LOOP, Roseburg, OR 97471
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Other Names 1

Doing Business AsWhite Oak Medical Center

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D2341536

White Oak Medical Center · Roseburg, OR
Active · expires Apr 2, 2028
CLIA Number38D2341536
Laboratory TypePhysician Office
Certificate Effective DateApril 3, 2026
Certificate Expiration DateApril 2, 2028
Laboratory DirectorRachel Hebert
Laboratory Phone(541) 464-5907
Laboratory LocationWhite Oak Medical Center341 Medical Loop, Ste 110, Roseburg, OR 97471
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 38D1015662

White Oak Medical Center · Roseburg, OR
Active · expires Aug 10, 2027
CLIA Number38D1015662
Laboratory TypePhysician Office
Certificate Effective DateAugust 11, 2025
Certificate Expiration DateAugust 10, 2027
Laboratory DirectorRachel Hebert
Laboratory Phone(541) 464-5907
Laboratory LocationWhite Oak Medical Center340 Medical Loop, Roseburg, OR 97471
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARIE HEBERT M.D.
Family Medicine
340 NW MEDICAL LOOP
ROSEBURG, OR 97471
Douglas County (541) 464-5907
WHITE OAK MEDICAL CLINIC LLC
Clinic/Center (Primary Care)
340 NW MEDICAL LOOP
ROSEBURG, OR 97471
Douglas County (541) 464-5907
RACHEL HEBERT FNP
Nurse Practitioner (Family)
340 NW MEDICAL LOOP
ROSEBURG, OR 97471
Douglas County (541) 733-8206
ROSEBURG FAMILY MEDICINE
Family Medicine
340 NW MEDICAL LOOP
ROSEBURG, OR 97471
Douglas County (541) 677-6599
PACIFIC HEALTHCARE SERVICES, P.C.
Clinic/Center
340 NW MEDICAL LOOP
ROSEBURG, OR 97471
Douglas County (541) 464-5907
STEVEN MICHAEL PRUDENCIO FNP
Family Medicine
340 NW MEDICAL LOOP
ROSEBURG, OR 97471
Douglas County (541) 464-5907
CYNTHIA J KEYS P.A.-C.
Physician Assistant (Medical)
340 NW MEDICAL LOOP
ROSEBURG, OR 97471
Douglas County (541) 677-6599
EMMANUELLE HEBERT
Nurse Practitioner (Family)
340 NW MEDICAL LOOP
ROSEBURG, OR 97471
Douglas County (541) 464-5907

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is White Oak Medical Clinic LLC's NPI number?

The NPI number for White Oak Medical Clinic LLC is 1043003114. It was assigned to this organization in the NPPES registry on May 22, 2025. The provider is doing business as White Oak Medical Center.

Where is White Oak Medical Clinic LLC located?

White Oak Medical Clinic LLC is located at 340 NW Medical Loop, Roseburg, OR 97471. The listed phone number is (541) 464-5907.

What is White Oak Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does White Oak Medical Clinic LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does White Oak Medical Clinic LLC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list White Oak Medical Clinic LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for White Oak Medical Clinic LLC was last updated on May 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.