WHITE OAK FAMILY MEDICINE CLINIC, LLC (NPI# 1073759502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073759502 |
| Entity Type | Organization |
| Organization Name | WHITE OAK FAMILY MEDICINE CLINIC, LLC |
| Practice Address |
1190 S 18th Street Ext Oxford MS 38655-5378 |
| Practice Telephone | 6622361927 |
| Practice Fax Number | 6622363727 |
| Mailing Telephone | 6622361927 |
| Mailing Fax Number | 6622363727 |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2010-01-11 |
| Authorized Official Name | MR. ERIK S RICHARDSON (OWNER) |
| Authorized Official Telephone | 6622361927 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
17356 | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | GROUP PTAN | 302G088746 | 01 |
| MS | INDIVIDUAL PTAN | 302I088746 | 01 |
| Street Address |
1190 S 18TH STREET EXT |
| City | OXFORD |
| State | MS |
| Zip Code | 38655-5378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861423790 | Russell Talmage Johnson | Specialist/Technologist | 1190 S 18th Street Ext, Oxford, MS 38655-5378 | 2006-07-06 |
| 1356359988 | Erik Scott Richardson | Family Medicine | 1190 S 18th Street Ext, Oxford, MS 38655-5378 | 2006-08-03 |
| 1578589263 | Jennifer Rebecca Moore | Specialist/Technologist | 1190 S 18th Street Ext, Oxford, MS 38655-5378 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619585809 | Oxford Treatment Center, LLC | Substance Abuse Rehabilitation Facility | 616 Commerce Parkway, Oxford, MS 38655 | 2020-07-14 |
| 1760044465 | Lindsay Low Beauchamp | Speech-Language Pathologist | 169 Ms-6 #102, Oxford, MS 38655 | 2019-07-02 |
| 1861058075 | Tomiko D Mackey | Social Worker | 100 Carriage Cove, Oxford, MS 38655 | 2019-05-13 |
| 1174090039 | Derionne Brooks | Specialist/Technologist | 972 Hathorn Road, University, MS 38655 | 2018-10-30 |
| 1497236327 | Providence Companion Care | Nurse's Aide | 317 Heritage Dr Ste 3b, Oxford, MS 38655 | 2018-08-28 |
| 1255817292 | Marcela Caroline Weber | Counselor | 152 Mississippi 7 South, Oxford, MS 38655 | 2018-07-12 |
| 1649775123 | Oxford Outpatient Center, LLC | Clinic/Center | 611 Commerce Pkwy, Oxford, MS 38655 | 2018-03-27 |
| 1073039962 | Sharon Yvette Holloway | Social Worker | 152 Hwy and South, Oxford, Ms 38655, Oxford, MS 38655 | 2017-08-22 |
| 1447774682 | Courtney M Purvis | Physical Therapist | 300 Enterprise Dr Ste B, Oxford, MS 38655 | 2017-07-31 |
| 1649716580 | Taylor Lynn Smith | Counselor | 152 Ms-7, Oxford, MS 38655 | 2017-01-17 |
| Find all providers in zip 38655 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1972894293 | Oxford Clinic LLC | Clinic/Center | 1713 Hamric Dr E, Oxford, AL 36203-2015 | 2011-04-20 |
| 1386956837 | Allcare Mississippi, LLC | Clinic/Center | 301 Jackson Ave W, Oxford, MS 38655-2154 | 2010-07-12 |
| 1114117140 | Robin Mahabir, M.d, P.c | Clinic/Center | 100 Oxford Rd, Oxford, CT 06478-1990 | 2007-07-26 |
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| 1124505912 | Thaxton Family Medical Clinic LLC | Clinic/Center | 11145 Highway 6 W, Thaxton, MS 38871-9024 | 2018-07-24 |
| 1316439615 | Quad/med, LLC | Clinic/Center | 1000 Jere St. Pe' Hwy, C/o Ingalls Main Substation, 1st Floor, Pascagoula, MS 39567 | 2018-06-01 |
| 1194215681 | Brooks Medical Clinic | Clinic/Center | 2113 South Tate Street, Corinth, MS 38834 | 2018-05-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.