White Oak Medical Clinic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

WHITE OAK MEDICAL CLINIC LLC

Practice address

340 NW Medical Loop
Roseburg, OR 97471-1645

Phone

(541) 464-5907

Fax

(541) 464-8481

NPI assigned

Nov 20, 2018

Last updated

May 22, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Diane Bolduc, MDNPI 1174537047

Title

President

Phone

(541) 464-5907

Specialties & licenses 5

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Diane Bolduc, M.D.

  • Family Medicine Physician
  • Roseburg, OR
  • NPI 1174537047
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1205305190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 NW MEDICAL LOOP",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711645",
            "telephone_number": "541-464-5907",
            "fax_number": "541-464-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 NW MEDICAL LOOP",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711645",
            "telephone_number": "541-464-5907",
            "fax_number": "541-464-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE OAK MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-20",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "BOLDUC",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-464-5907",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trina Wheeldon
• Gary E Wheeler, MD
• Shea Leigh Wheeler, QMHA
• Mackenzy James Whetzel, PSS
• White Oak Medical Clinic LLC (White Oak Medical Center)
• Alexandra White, AUD
• David H White, DMD
• Trevar John White
• Rachael Whiteberg
• Karla Whitlock, MA, LPC

• Primary Care Clinic/Center in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Primary Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.