PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1194126268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194126268 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | DUKE SIGNATURE CARE - CARY |
| Practice Address |
530 New Waverly Pl Suite 101 Cary NC 27518-7414 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9192333959 |
| Mailing Telephone | 9196204700 |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2014-09-11 |
| Authorized Official Name | CHRISTOPHER T FREDERICK (CFO) |
| Authorized Official Telephone | 9196137762 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Duke Signature Care - Cary | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538616289 | Private Diagnostic Clinic, Pllc | Neurological Surgery | 1212 Cedarhurst Dr Ste 102, Raleigh, NC 27609-5588 | 2016-09-09 |
| 1083168181 | Private Diagnostic Clinic, Pllc | Internal Medicine | 10207 Cerny St Ste 306, Raleigh, NC 27617-4879 | 2016-08-08 |
| 1124459292 | Private Diagnostic Clinic, Pllc | Occupational Therapist | Duke Clinic 1e, 40 Duke Medicine Circle, Durham, NC 27710-0001 | 2013-11-27 |
| 1609116664 | Private Diagnostic Clinic, Pllc | Dermatology | 82 Wheaton Ave, Youngsville, NC 27596-8691 | 2013-02-27 |
| 1487903423 | Private Diagnostic Clinic, Pllc | Pediatrics | 540 New Waverly Place, Ste.101, Cary, NC 27518-7422 | 2012-09-06 |
| 1558639864 | Private Diagnostic Clinic, Pllc | Allergy & Immunology | 30 Duke Medicine Circle, Durham, NC 27710-3000 | 2011-12-01 |
| 1972826568 | Private Diagnostic Clinic, Pllc | Family Medicine | 800 Clayton Rd, Durham, NC 27703-2606 | 2010-03-10 |
| 1891021853 | Private Diagnostic Clinic, Pllc | Obstetrics & Gynecology | 2406 Blue Ridge Road, Suite 200, Raleigh, NC 27607-6680 | 2009-10-27 |
| 1447480413 | Private Diagnostic Clinic, Pllc | Orthopaedic Surgery | 511 Ruin Road, Suite 106, Henderson, NC 27536-5919 | 2009-07-23 |
| 1841446762 | Private Diagnostic Clinic, Pllc | Otolaryngology | 783 Doctors Ct Ste C, Roxboro, NC 27573-4575 | 2008-08-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PRIVATE DIAGNOSTIC CLINIC, PLLC | Duke University Medical Center, Durham, NC 27710-0001 |
| Street Address |
530 NEW WAVERLY PL SUITE 101 |
| City | CARY |
| State | NC |
| Zip Code | 27518-7414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518966886 | Michael Malik | Surgery | 530 New Waverly Pl, Ste. 304, Cary, NC 27518-7414 | 2005-07-19 |
| 1912478496 | Wake Specialty Physicians LLC | Surgery | 530 New Waverly Pl, Cary, NC 27518-7414 | 2018-12-10 |
| 1467866152 | Triangle Wellness Pllc | Family Medicine | 530 New Waverly Pl, Suite 301, Cary, NC 27518-7414 | 2014-06-20 |
| 1598022394 | Garett Randall Franklin | Family Medicine | 530 New Waverly Pl, Suite 200, Cary, NC 27518-7414 | 2012-04-18 |
| 1912137365 | Sridevi Allu | Family Medicine | 530 New Waverly Pl, Suite 200, Cary, NC 27518-7414 | 2009-07-20 |
| 1104012343 | Raleigh Durham Medical Group Pa | Surgery | 530 New Waverly Pl, Ste. 304, Cary, NC 27518-7414 | 2007-09-21 |
| 1417086117 | Audrey C Avitabile | Nurse Practitioner | 530 New Waverly Pl, Suite 200, Cary, NC 27518-7414 | 2007-03-06 |
| 1457494254 | Rebecca Ann Boettcher | Nurse Practitioner | 530 New Waverly Pl, Suite 200, Cary, NC 27511-7414 | 2007-02-14 |
| 1912049669 | Sylvia Piqueras Shoffner | Internal Medicine | 530 New Waverly Pl, Suite 200, Cary, NC 27511-7414 | 2007-02-12 |
| 1063553436 | Susan Lawrence Crittenden | Internal Medicine | 530 New Waverly Pl, Suite 200, Cary, NC 27511-7414 | 2007-02-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932730801 | Fuller & Associates Iv, Pllc | Dentist | 3420 Ten-ten Road, Suite 310, Cary, NC 27518 | 2020-01-30 |
| 1649761602 | Uday N Reebye, Md. Dmd, Pa | Dentist | 431 Keisler Dr Ste 101, Cary, NC 27518 | 2018-05-25 |
| 1164912093 | Cary Dental Rejuvenation | Dentist | 155 Parkway Office Court, Suite 104, Cary, NC 27518 | 2018-05-16 |
| 1104337021 | Kaylah Mckinley Black | Nurse Practitioner | 530 New Waverly Pl Ste 301, Cary, NC 27518 | 2017-10-18 |
| 1013442961 | Amber Pinsky | Occupational Therapist | 5310 Woodfield Lake Road, Cary, NC 27518 | 2017-04-28 |
| 1750733564 | Maureen Lyons Reardon | Psychologist | 2500 Regency Parkway, Cary, NC 27518 | 2016-07-05 |
| 1730539651 | Anna Liakh | Dentist | 8204 Tryon Woods Dr, Cary, NC 27518 | 2016-06-21 |
| 1609236173 | Matthew John Myschisin II | Chiropractor | 4312 Farm Brook Dr, Cary, NC 27518 | 2016-02-26 |
| 1003299405 | Amanda Lee Morris | Social Worker | 531 Keisler Dr Ste 104, Cary, NC 27518 | 2015-07-02 |
| 1053791343 | Duke University Affiliated Physicians | Family Medicine | 530 Waverly Place, Suite 101, Cary, NC 27518 | 2015-06-02 |
| Find all providers in zip 27518 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076222 | Raleigh Holistic Healthcare | Internal Medicine | 875 Walnut St Ste 275-9, Cary, NC 27511-4215 | 2020-09-01 |
| 1134682792 | Carolinas Weight Loss & Personailzed Care | Internal Medicine | 210 New Edition Ct, Cary, NC 27511-4451 | 2019-04-10 |
| 1962900043 | Michael Klepper | Internal Medicine | 102 Lulworth Ct, Cary, NC 27519-6652 | 2018-01-24 |
| 1225494156 | Vester Walker Jr. | Internal Medicine | 301 Versailles Dr, Cary, NC 27511-6012 | 2016-01-07 |
| 1417327818 | Nirupama B Shah | Internal Medicine | 100 Escher Ln, Cary, NC 27511-4851 | 2015-09-29 |
| 1083017693 | Jennings Ray Dawkins | Internal Medicine | 103 Great Point Pl, Cary, NC 27513-2969 | 2014-09-27 |
| 1619225240 | Elizabeth Anne Campbell | Internal Medicine | 120 Braelands Drive, Cary, NC 27518-8972 | 2012-08-29 |
| 1548528375 | Ryan Keith Brown | Internal Medicine | 530 New Waverly Pl Ste 200, Cary, NC 27518-7414 | 2012-04-30 |
| 1013214998 | William V. Lorimer, M.d. Pllc | Internal Medicine | 661 Lipford Dr, Cary, NC 27519-7073 | 2011-02-11 |
| 1780980219 | Carolina Pulmonary & Sleep Clinic Pllc | Internal Medicine | 3750 Nw Cary Pkwy Ste 120, Cary, NC 27513-8432 | 2011-01-31 |
| Find all providers in CARY | ||||
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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.