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Organization Active NPI

White Oak Manor Inc

Doing business as White Oak Manor Rock Hill

  • Skilled Nursing Facility
  • Rock Hill, SC
National Provider Identifier
1457486474
Registry record updated Nov 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NCF-885 Issued in SC
Legal business name
WHITE OAK MANOR INC
Doing business as
White Oak Manor Rock Hill
Practice address
1915 Ebenezer Rd
Rock Hill, SC 29732-1013
Phone
(803) 366-8155
Fax
(803) 366-8158
NPI assigned
Feb 22, 2007
Last updated
Nov 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2008

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

Authorized official

Name
Mr. David Joe Haney
Title
VP Finance
Phone
(864) 327-1162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NCF-885 SC Primary

Addresses

Primary practice location

1915 Ebenezer Rd
Rock Hill, SC 29732-1013

Mailing address

PO Box 3347
Spartanburg, SC 29304-3347
Phone (803) 366-8155

Other identifiers 2

IdentifierTypeStateIssuer
5260320001OtherSCNSC MEDICARE ID-PTAN
0459NHMedicaidSC

Other names 1

  • White Oak Manor Rock Hill Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120220000744 SC Part A Provider - Skilled Nursing Facility 3173511458 Practice locations: Rock Hill, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457486474. Details of each certification follow.

Skilled nursing facility certification: CCN 425088

Legal name
WHITE OAK MANOR INC
Doing business as
WHITE OAK MANOR ROCK HILL
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 15, 1972
Last certification
Mar 13, 2025
Beds
140 (136 certified)
Ownership / control type
Limited Liability Corporation
Multi-facility organization
NHC Healthcare
Organization structure
CorporationProprietary
Incorporated
Oct 1, 2002 in SC
Enrollment address
1915 Ebenezer Rd
Rock Hill, SC 29732-1013

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
White Oak Manor - Rock HillCCN 425088 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jun 15, 1972
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
136134.9 residents per day on average
Penalties (3 years)
1Fines totaling $7,446

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Member of 6

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jeni C Feeser Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2022 21%
Corporate DirectorBoard Member Oct 1, 2002 5%
Jerrolyn Montgomery-Smalls Individual W-2 Managing EmployeeAdministrator Apr 17, 2023 25%
Dorothy D Cecil Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2022 21%
Corporate DirectorBoard Member Oct 1, 2002 5%
White Oak Management, Inc. Organization, Spartanburg, SC Management services company Operational/Managerial Control Oct 1, 2002 24%
White Oak Manor Inc Organization, Spartanburg, SC Corporation 5% Or Greater Direct Ownership Interest Oct 1, 2002 100%
Oliver K Cecil Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2022 18%
Corporate OfficerCeo Oct 1, 2002 5%
Corporate DirectorBoard Member Oct 1, 2002 5%
Tamara Elizabeth Chittenden Individual Contracted Managing EmployeeMedical Director Feb 28, 2024 5%
Beth C Cecil Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2022 21%
Corporate DirectorBoard Member Oct 1, 2002 5%
Douglas M Cecil Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2022 19%
Corporate OfficerPresident Oct 1, 2002 5%
Corporate DirectorBoard Member Oct 1, 2002 5%
David J Haney Individual Corporate OfficerVP of Finance Oct 1, 2002 1%
John P Barber Individual Corporate OfficerCfo Oct 1, 2002 5%
Corporate DirectorBoard Member Oct 1, 2002 5%

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
White Oak Manor Tryon IncTryon, NC, CCN 345127 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2002
White Oak Manor Kings Mountain Inc.Kings MTN, NC, CCN 345151 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2002
White Oak Manor Charlotte IncCharlotte, NC, CCN 345238 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2002
White Oak EstatesSpartanburg, SC, CCN 425290 Skilled nursing facility 5% Or Greater Direct Ownership Interest Nov 16, 2009
White Oak of WaxhawWaxhaw, NC, CCN 345550 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 25, 2010
White Oak Manor LancasterLancaster, SC, CCN 425017 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2002
White Oak Manor ColumbiaColumbia, SC, CCN 425068 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2002
White Oak Manor NewberryNewberry, SC, CCN 425077 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2002
White Oak at North Grove IncSpartanburg, SC, CCN 425408 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 2, 2015

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 10

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225843200000",
    "number": "1457486474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3347",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293043347",
            "telephone_number": "803-366-8155",
            "fax_number": "803-366-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 EBENEZER RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321013",
            "telephone_number": "803-366-8155",
            "fax_number": "803-366-8158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE OAK MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-11-05",
        "status": "A",
        "authorized_official_last_name": "HANEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JOE",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "864-327-1162",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "SC",
            "license": "NCF-885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC MEDICARE ID-PTAN",
            "identifier": "5260320001",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0459NH",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Oak Manor Rock Hill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.