White Oak Primary Care, Inc.
Organization Active NPI Primary Care Clinic/Center · Halifax, VA
NPI 1639799166 · NPPES record last updated Apr 24, 2020
Key facts
- NPI
- 1639799166
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- WHITE OAK PRIMARY CARE, INC.
- Practice address
- 235 N Main St
Halifax, VA 24558-2995 - Phone
- (434) 830-2605
- Fax
- (434) 830-2258
- NPI assigned
- Apr 24, 2020
- Organization subpart
- No
Authorized official
- Name
- Dr. Shannon N Scearce, DNP, FNP-C
- Title
- Owner/President/Provider
- Phone
- (434) 830-2605
Practitioners 4
-
Shannon N Scearce, DNP, FNP-C
-
Kimberly Lloyd Jones, LPN
-
Brenda Sue Waller, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D2180427 | White Oak Primary Care | Provider-performed microscopy | Mar 12, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200506001478 | VA | Part B Supplier - Clinic/Group Practice | 8628409695 |
Receives reassigned benefits from 1 practitioner Practice locations: Halifax, VA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
235 N Main St
Halifax, VA 24558-2995
Mailing address
235 N Main St
Halifax, VA 24558-2995
Phone (434) 830-2605
Other providers in Halifax, VA
- Shannon N Scearce
- Harvey Abraham Smith
- Strategic Therapy Associates
- Herman Lee Thomas Jr.
- Bettina H Walker
- Youngers Adult Home
- Megan Jean Zamora
All providers in Halifax, VA · Primary Care Clinic/Center in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.