PRIVATE DIAGNOSTIC CLINIC, PLLC


Address: 4709 Creekstone Dr, Suite 100, Durham, NC 27703-8411
Phone: 9196605060

PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1285916635) 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) 1285916635
Entity Type Organization
Organization Name PRIVATE DIAGNOSTIC CLINIC, PLLC
Other Organization Name DUKE EYE CENTER AT PAGE ROAD
Practice Address 4709 Creekstone Dr
Suite 100
Durham
NC 27703-8411
Mailing Address Po Box 63362
Charlotte
NC 28263-3362
Practice Telephone 9196605060
Mailing Telephone 9196848111
Mailing Fax Number 9196204921
Enumeration Date 2011-09-12
Last Update Date 2011-12-09
Authorized Official Name MR. MARK L. CANTRELL (CHIEF PRIVACY & COMPLIANCE OFFICER)
Authorized Official Telephone 9196848111
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207W00000X Ophthalmology Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Duke Eye Center at Page Road 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 4709 CREEKSTONE DR
SUITE 100
City DURHAM
State NC
Zip Code 27703-8411

Providers in the same location

NPI Name Taxonomy Address Enumeration
1316902398 Jessica Kristen Allen Physician Assistant 4709 Creekstone Dr, Durham, NC 27703-8411 2006-04-20
1073161196 Chelsea Espinoza Occupational Therapist 4709 Creekstone Dr, Durham, NC 27703-9822 2019-09-02
1396305496 Jennifer Trahan Physical Therapist 4709 Creekstone Dr, Durham, NC 27703-9822 2019-06-19
1437621679 Hannah Aldridge Specialist/Technologist 4709 Creekstone Dr, Durham, NC 27703-9822 2018-12-28
1699211920 Bryan Hoch Physical Therapist 4709 Creekstone Dr, Duke Page Rd Pt/ Ot, Durham, NC 27703-9822 2017-01-10
1417402462 Private Diagnostic Clinic, Pllc Prosthetic/Orthotic Supplier 4709 Creekstone Dr, Suite 300, Durham, NC 27703-9822 2016-08-19
1679940811 Lucy Margaret Beatty Occupational Therapist 4709 Creekstone Dr, Durham, NC 27703-9822 2015-08-24
1295174498 Martha Sizemore Aitken Nurse Practitioner 4709 Creekstone Dr, Durham, NC 27703-8411 2013-06-20
1730473869 Private Diagnostic Clinic, Pllc Orthopaedic Surgery 4709 Creekstone Dr, Suite 300, Durham, NC 27703-8411 2011-06-07
1518271279 Yos M Priestley Optometrist 4709 Creekstone Dr, Ste 100, Durham, NC 27703-8411 2010-08-04
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1285235218 Joseph Omalemigbo Abgateyiniro Durable Medical Equipment & Medical Supplies 1810 Shiva Court, Durham, NC 27703 2020-11-05
1326654278 Step By Step In Home Care LLC Home Health Imperial Business Park, 4819 Emperor Blvd Suite 400, Durham, NC 27703 2020-09-16
1023598463 Impact Therapy Services Speech-Language Pathologist 6 Winnabow Court, Durham, NC 27703 2018-08-15
1326536327 Renal Treatment Centers - Mid-atlantic, Inc. Clinic/Center 1100 N Miami Blvd Ste 500a, Durham, NC 27703 2018-04-25
1033621719 Duke University Preventive Medicine 4825 Creekstone Drive, Suite 105, Durham, NC 27703 2017-11-02
1023535564 Walgreen Co Durable Medical Equipment & Medical Supplies 3725 Wake Forest Hwy, Durham, NC 27703 2017-08-25
1487194171 Shivani L. Chudasama Social Worker 5475 Lumley Rd Ste 103, Durham, NC 27703 2017-03-01
1356886030 Rgh Enterprises, Inc. Durable Medical Equipment & Medical Supplies 4234 Surles Court, Suite 100, Durham, NC 27703 2017-01-04
1780032821 Victory Speech Therapy Services, Pllc Speech-Language Pathologist 1533 Ellis Rd., Apt J208, Durham, NC 27703 2016-05-31
1124422373 Helene Azimbi Fonebi Pharmacist 8 Gandhi Dr, Durham, NC 27703 2014-10-17
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Taxonomy Information

Taxonomy Code 207W00000X
Grouping Allopathic & Osteopathic Physicians
Classification Ophthalmology

Taxonomy Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1598221848 Eye Physicians and Surgeons of Durham, Pllc Ophthalmology 3811 North Roxboro Street, Durham, NC 27704-5800 2019-02-12
1801271457 Asghar Haider Ophthalmology 2351 Erwin Road, Durham, NC 27710-3036 2015-07-24
1114260163 Jay Berdia Ophthalmology 2531 Erwin Rd, Durham, NC 27705 2013-03-28
1912266404 Andrew Freeman Perin Ophthalmology 2351 Erwin Road/hudson Building, Duke Eye Center, Attn: Andrew Perin, Md, Durham, NC 27705 2012-05-03
1184980609 Varsha Manjunath Ophthalmology 270 Leigh Farm Rd, Apt 408, Durham, NC 27707-8137 2012-04-10
1043449218 Zena I-linn Lim Ophthalmology Duke University Medical Center 3802, 2351 Erwin Road, Durham, NC 27710-0001 2009-07-09
1831356716 Anna Hong Bordelon Ophthalmology 2351 Erwin Road Dumc Box 3802, Durham, NC 27710-0001 2008-05-19
1023285988 Preeya Kshettry Gupta Ophthalmology 2351 Erwin Rd # Dumc3802, Durham, NC 27705-4699 2008-05-09
1871777953 Sasapin Grace Prakalapakorn Ophthalmology 2351 Erwin Rd; Dumc 3802, Duke Eye Center; Attn: Kimberly Horton, Durham, NC 27710-0001 2007-12-25
1326247545 Joseph Nissim Martel Ophthalmology Duke Eye Ctr, Dumc 3802, Durham, NC 27710-0001 2007-07-17
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City DURHAM
Zip Code 27703

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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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