WHITE OAK MEDICAL CLINIC
NPI 1962110031
Nurse Practitioner - Primary Care in Hector, AR
About White Oak Medical Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WHITE OAK MEDICAL CLINIC (NPI 1962110031) is a healthcare organization registered as a primary care in Hector, Arkansas and active in the NPI registry since November 2022. The organization holds a CLIA Waiver certificate valid through March 9, 2027 and lists Maranda Moore, Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
White Oak Medical Clinic 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 White Oak Medical Clinic, 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.
CLIA Laboratory Certificates CMS CLIA
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 04D2278094
White Oak Medical Clinic · Hector, ARFrequently 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's NPI number?
The NPI number for White Oak Medical Clinic is 1962110031. It was assigned to this organization in the NPPES registry on November 8, 2022.
Where is White Oak Medical Clinic located?
White Oak Medical Clinic is located at 11442 Sr 27, Hector, AR 72843. The listed phone number is (479) 264-4455.
What is White Oak Medical Clinic's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is White Oak Medical Clinic enrolled in Medicare?
Yes. White Oak Medical Clinic is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through White Oak Medical Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to White Oak Medical Clinic. 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.
Does White Oak Medical Clinic hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 04D2278094) is associated with this NPI, valid through March 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for White Oak Medical Clinic was last updated on March 22, 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.
# White Oak Medical Clinic · NPI 1962110031
Primary Care organization in Hector, Arkansas. Organization record, active in the CMS NPPES registry since November 8, 2022.
## Identity
- **NPI:** 1962110031 (Entity type: Organization)
- **Enumerated:** November 8, 2022
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **Organization subpart:** No
- **Authorized official:** Maranda Moore, MANAGER
## Practice location
- **Address:** 11442 SR 27, Hector, AR 72843-9102
- **Phone:** (479) 264-4455
## 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:** March 22, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1962110031) · Data from the CMS NPPES public registry.