Active NPI
White Oak Manor Inc
- Skilled Nursing Facility
- Newberry, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- NCF-884
- Legal business name
- WHITE OAK MANOR INC
- Practice address
- 2555 Kinard St
Newberry, SC 29108-2954 - Phone
- (803) 276-6060
- Fax
- (803) 321-9244
- NPI assigned
- Feb 22, 2007
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NCF-884 | SC | Primary |
Addresses
Primary practice location
2555 Kinard St
Newberry, SC 29108-2954
Mailing address
PO Box 3347
Spartanburg, SC 29304-3347
Phone (803) 276-6060
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0462NH | Medicaid | SC | |
| 5217260001 | Other | SC | NSC MEDICARE ID-PTAN |
Other names 1
- White Oak Manor Newberry
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120224000658 | SC | Part A Provider - Skilled Nursing Facility | 3173511458 | Practice locations: Newberry, SC |
Skilled nursing facility certification: CCN 425077
- Legal name
- WHITE OAK MANOR INC
- Doing business as
- WHITE OAK MANOR NEWBERRY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 25, 1971
- Last certification
- Apr 18, 2025
- Beds
- 140
- Ownership / control type
- Corporation
- Multi-facility organization
- NHC Healthcare
- Organization structure
- Corporation
- Incorporated
- Oct 1, 2002 in SC
- Enrollment address
- 2555 Kinard St
Newberry, SC 29108-2954 - Nursing home name
- WHITE OAK MANOR - NEWBERRY
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 - Newberry
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jun 25, 1971
- Medicare certification status
- Active
- Certified beds
- 140
National Provider Directory
National Provider DirectoryMember of 7
Organizations this organization is a member of, according to the National Provider Directory.
-
- Skilled Nursing Facility
- Kings Mountain, NC
- NPI 1033244090
Member Of
-
- Skilled Nursing Facility
- Rutherfordton, NC
- NPI 1639204282
Member Of
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Jeni C Feeser | 5% Or Greater Indirect Ownership Interest | Feb 1, 2022 | 21% |
| Corporate Director | Oct 1, 2002 | 5% | |
| Dorothy D Cecil | 5% Or Greater Indirect Ownership Interest | Feb 1, 2022 | 21% |
| Corporate Director | Oct 1, 2002 | 5% | |
| White Oak Management, Inc. | Operational/Managerial Control | Oct 1, 2002 | 24% |
| White Oak Manor Inc | 5% Or Greater Direct Ownership Interest | Oct 1, 2002 | 100% |
| Michael Bernardo | Contracted Managing Employee | Feb 28, 2024 | 5% |
| Oliver K Cecil | 5% Or Greater Indirect Ownership Interest | Feb 1, 2022 | 18% |
| Corporate Officer | Oct 1, 2002 | 5% | |
| Corporate Director | Oct 1, 2002 | 5% | |
| Beth C Cecil | 5% Or Greater Indirect Ownership Interest | Feb 1, 2022 | 21% |
| Corporate Director | Oct 1, 2002 | 5% | |
| Douglas M Cecil | 5% Or Greater Indirect Ownership Interest | Feb 1, 2022 | 19% |
| Corporate Officer | Oct 1, 2002 | 5% | |
| Corporate Director | Oct 1, 2002 | 5% | |
| David J Haney | Corporate Officer | Oct 1, 2002 | 1% |
| John P Barber | Corporate Officer | Oct 1, 2002 | 5% |
| Corporate Director | Oct 1, 2002 | 5% | |
| Melissa Shields Gilliam | W-2 Managing Employee | May 1, 2024 | 25% |
Owners & managing parties with NPI records 6
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Newberry, SC
- NPI 1598764870
Contracted Managing Employee
-
- Skilled Nursing Facility
- Lancaster, SC
- NPI 1073648002
5% Or Greater Direct Ownership Interest
-
- Skilled Nursing Facility
- Rock Hill, SC
- NPI 1457486474
5% Or Greater Direct Ownership Interest
-
- Skilled Nursing Facility
- Columbia, SC
- NPI 1659406668
5% Or Greater Direct Ownership Interest
-
- Skilled Nursing Facility
- Spartanburg, SC
- NPI 1730214768
5% Or Greater Direct Ownership Interest
-
- Skilled Nursing Facility
- Spartanburg, SC
- NPI 1467993030
5% Or Greater Direct Ownership Interest
All facility ownership & control disclosures 9
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| White Oak Manor Tryon Inc | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Oct 1, 2002 |
| White Oak Manor Kings Mountain Inc. | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Oct 1, 2002 |
| White Oak Manor Charlotte Inc | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Oct 1, 2002 |
| White Oak Estates | Skilled nursing facility | 5% Or Greater Direct Ownership Interest | Nov 16, 2009 |
| White Oak of Waxhaw | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jan 25, 2010 |
| White Oak Manor Lancaster | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Oct 1, 2002 |
| White Oak Manor Rock Hill | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Oct 1, 2002 |
| White Oak Manor Columbia | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Oct 1, 2002 |
| White Oak at North Grove Inc | 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.
-
- Skilled Nursing Facility
- Lancaster, SC
- NPI 1073648002
5% Or Greater Direct Ownership Interest
-
- Skilled Nursing Facility
- Rock Hill, SC
- NPI 1457486474
5% Or Greater Direct Ownership Interest
-
- Skilled Nursing Facility
- Columbia, SC
- NPI 1659406668
5% Or Greater Direct Ownership Interest
-
- Skilled Nursing Facility
- Spartanburg, SC
- NPI 1730214768
5% Or Greater Direct Ownership Interest
-
- Skilled Nursing Facility
- Spartanburg, SC
- NPI 1467993030
5% Or Greater Direct Ownership Interest
-
- Skilled Nursing Facility
- Charlotte, NC
- NPI 1366577355
5% Or Greater Direct Ownership Interest
-
- Skilled Nursing Facility
- Kings Mountain, NC
- NPI 1033244090
5% Or Greater Direct Ownership Interest
-
- Skilled Nursing Facility
- Tryon, NC
- NPI 1356476311
5% Or Greater Direct Ownership Interest
-
- Skilled Nursing Facility
- Waxhaw, NC
- NPI 1124342241
5% Or Greater Direct Ownership Interest
Facilities with the same owner 10
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Lancaster, SC
- NPI 1073648002
White Oak Management, Inc., White Oak Manor Inc
-
- Skilled Nursing Facility
- Rock Hill, SC
- NPI 1457486474
White Oak Management, Inc., White Oak Manor Inc
-
- Skilled Nursing Facility
- Columbia, SC
- NPI 1659406668
White Oak Management, Inc., White Oak Manor Inc
-
- Skilled Nursing Facility
- Spartanburg, SC
- NPI 1730214768
White Oak Management, Inc., White Oak Manor Inc
-
- Skilled Nursing Facility
- Spartanburg, SC
- NPI 1467993030
White Oak Management, Inc., White Oak Manor Inc
-
- Skilled Nursing Facility
- Charlotte, NC
- NPI 1366577355
White Oak Management, Inc., White Oak Manor Inc
-
- Skilled Nursing Facility
- Kings Mountain, NC
- NPI 1033244090
White Oak Management, Inc., White Oak Manor Inc
-
- Skilled Nursing Facility
- Tryon, NC
- NPI 1356476311
White Oak Management, Inc., White Oak Manor Inc
-
- Skilled Nursing Facility
- Waxhaw, NC
- NPI 1124342241
White Oak Management, Inc., White Oak Manor Inc
Practitioners & affiliated clinicians
Affiliated clinicians 2
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": "1689709693",
"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": "803-276-6060",
"fax_number": "803-321-9244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2555 KINARD ST",
"city": "NEWBERRY",
"state": "SC",
"postal_code": "291082954",
"telephone_number": "803-276-6060",
"fax_number": "803-321-9244"
}
],
"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-884",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0462NH",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NSC MEDICARE ID-PTAN",
"identifier": "5217260001",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "White Oak Manor Newberry",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Newberry, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.