PRIVATE DIAGNOSTIC CLINIC, PLLC


Address: 3400 Wake Forest Rd, Raleigh, NC 27609-7317
Phone: 9199543000

PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1205150380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1205150380
Entity Type Organization
Organization Name PRIVATE DIAGNOSTIC CLINIC, PLLC
Other Organization Name DUKE RALEIGH HOSPITAL (PDC)
Practice Address 3400 Wake Forest Rd
Raleigh
NC 27609-7317
Mailing Address Po Box 63362
Charlotte
NC 28263-3362
Practice Telephone 9199543000
Mailing Telephone 9196848111
Enumeration Date 2010-03-18
Last Update Date 2011-12-09
Authorized Official Name MR. MARK L CANTRELL (CHIEF PRIVACY & COMPLIANCE OFFICER)
Authorized Official Telephone 9196685161
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RP1001X Internal Medicine
Specialization: Pulmonary Disease
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Duke Raleigh Hospital (PDC) Doing Business As Name - Organization

Other Provider IDs and Locations

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

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities PRIVATE DIAGNOSTIC CLINIC, PLLC Duke University Medical Center, Durham, NC 27710-0001

Office Location

Street Address 3400 WAKE FOREST RD
City RALEIGH
State NC
Zip Code 27609-7317

Providers in the same location

NPI Name Taxonomy Address Enumeration
1013916352 Duke University Health System Inc General Acute Care Hospital 3400 Wake Forest Rd, Raleigh, NC 27609-7317 2005-07-19
1023632742 Rebecca D Griffin Nurse Anesthetist, Certified Registered 3400 Wake Forest Rd, Raleigh, NC 27609-7317 2020-05-29
1013536366 Melaine Roushini Rajanayagam Nurse Practitioner 3400 Wake Forest Rd, Raleigh, NC 27609-7317 2020-04-15
1902435969 Corey Michael Grindo Nurse Practitioner 3400 Wake Forest Rd, Raleigh, NC 27609-7317 2020-04-02
1659906303 Nicholas P Glover Nurse Anesthetist, Certified Registered 3400 Wake Forest Rd, Raleigh, NC 27609-7317 2020-03-03
1982247292 Coral Elyse Stevens Hodges Neurological Surgery 3400 Wake Forest Rd, Raleigh, NC 27609-7317 2019-10-21
1205477676 Joana Lule Hospitalist 3400 Wake Forest Rd, Raleigh, NC 27609-7317 2019-10-07
1780235119 Melissa V Moreda Clinical Nurse Specialist 3400 Wake Forest Rd, Raleigh, NC 27609-7317 2019-09-26
1871159202 Lindsey Theresa Hanley Nurse Practitioner 3400 Wake Forest Rd, Raleigh, NC 27609-7317 2019-05-10
1538629829 Megan Childs Student in an Organized Health Care Education/Training Program 3400 Wake Forest Rd, Raleigh, NC 27609-7317 2019-03-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1184235582 Choice Service Solutions LLC In Home Supportive Care 5300 Six Fox Rd Siite205, Raleigh, NC 27609 2020-08-11
1003426073 Rosana Oba -rovira Registered Nurse 5300 Six Fox Road, Suite 205, Raleigh, NC 27609 2020-08-05
1821612706 Helen Alexandra Bonner Physical Medicine & Rehabilitation Hey Clinic Pa, 3320 Wake Forest Road Ste 450, Raleigh, NC 27609 2020-06-05
1215423579 Appiah Nana Larbi Social Worker Easter Seals Ucp 4000 Wake Forest Rd Ste 200, Raleigh, NC 27609 2018-07-10
1215423777 Broadway Home Care LLC In Home Supportive Care 107 Windel Dr Ste 105, Raleigh, NC 27609 2018-07-09
1275027948 Lacey Allene Cottingham Social Worker 312 W Millbrook Rd Ste 129, Raleigh, NC 27609 2018-06-18
1447748819 Integrated Dermatology of North Raleigh, Pllc Dermatology 3809 Computer Dr Ste 200, Raleigh, NC 27609 2018-05-01
1902325418 Naomi Christine Askew Nurse Practitioner 3400 Wake Forest Drive, Bldg 9, Bldg #9, 4th Floor, Raleigh, NC 27609 2017-09-15
1962929679 Alexia Montague Social Worker 1306 Paddock Drive Suite E-100, Raleigh, NC 27609 2017-08-23
1730602236 Chantel Washington-mbuthia Counselor 1100 Logger Ct. Ste C100, Heartfelt Alternative Inc, Raleigh, NC 27609 2017-07-18
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Taxonomy Information

Taxonomy Code 207RP1001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Pulmonary Disease

Taxonomy Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1265506182 John Keven Griffith Internal Medicine 3421 Harden Rd, Raleigh, NC 27607-3305 2006-11-20
1952485005 Ted Kunstling Internal Medicine 3320 Wake Forest Rd Ste 200a, Raleigh, NC 27609-7300 2006-10-25
1063444602 Glenn D Crater Internal Medicine 1390 Capital Blvd, Raleigh, NC 27603-1118 2006-07-06
1245894898 Wakemed Specialists Group LLC Internal Medicine 3000 New Bern Ave, Raleigh, NC 27610-1231 2019-04-30
1144625658 Ahmed Sesay Internal Medicine 3000 New Bern Ave, Raleigh, NC 27610 2014-10-27
1154732196 Wake Specialty Physicians, LLC Internal Medicine 3000 New Bern Ave, Raleigh, NC 27610-1231 2014-05-13
1861777468 Rex Hospital Inc Internal Medicine 4414 Lake Boone Trl, Suite 402, Raleigh, NC 27607-7513 2011-10-14
1790075810 Sara Meehan Internal Medicine 4420 Lake Boone Trl, Raleigh, NC 27607 2011-04-11
1063716447 Rex Physicians LLC Internal Medicine 2800 Blue Ridge Rd, Suite 201, Raleigh, NC 27607-6478 2010-12-29
1336462191 Private Diagnostic Clinic, Pllc Internal Medicine 23 Sunnybrook Rd, Raleigh, NC 27610-1855 2010-03-09
Find all providers in RALEIGH

Competitor

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City RALEIGH
Zip Code 27609

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Dataset Information

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.

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