WILLOW OAK MEDICAL, LLC
NPI 1366224719
Clinic/Center - Primary Care in Clinton, IN
About Willow Oak Medical, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WILLOW OAK MEDICAL, LLC (NPI 1366224719) is a healthcare organization registered as a primary care in Clinton, Indiana and active in the NPI registry since October 2023. The organization lists Jeanie M Kent, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Willow Oak Medical, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Willow Oak Medical, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Willow Oak Medical, LLC's NPI number?
The NPI number for Willow Oak Medical, LLC is 1366224719. It was assigned to this organization in the NPPES registry on October 19, 2023.
Where is Willow Oak Medical, LLC located?
Willow Oak Medical, LLC is located at 100 S Main St, Clinton, IN 47842. The listed phone number is (912) 713-1124.
What is Willow Oak Medical, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Willow Oak Medical, LLC enrolled in Medicare?
Yes. Willow Oak Medical, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Willow Oak Medical, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Willow Oak Medical, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Willow Oak Medical, LLC was last updated on October 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.
# Willow Oak Medical, Llc · NPI 1366224719
Primary Care organization in Clinton, Indiana. Organization record, active in the CMS NPPES registry since October 19, 2023.
## Identity
- **NPI:** 1366224719 (Entity type: Organization)
- **Enumerated:** October 19, 2023
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Jeanie Kent, OWNER
## Practice location
- **Address:** 100 S MAIN ST, Clinton, IN 47842-2437
- **Phone:** (912) 713-1124
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 19, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1366224719) · Data from the CMS NPPES public registry.