PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1295990323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295990323 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | MARIA PARHAM ONCOLOGY CENTER |
| Practice Address |
566 Ruin Creek Rd Henderson NC 27536-2927 |
| Mailing Address |
Po Box 900002 Raleigh NC 27675-9000 |
| Practice Telephone | 2524361880 |
| Practice Fax Number | 2524361149 |
| Mailing Telephone | 9196848111 |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2010-04-21 |
| Authorized Official Name | JOHN P. DION (CFO-PDC) |
| Authorized Official Telephone | 9196137762 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
NC | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Maria Parham Oncology Center | 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 |
566 RUIN CREEK RD |
| City | HENDERSON |
| State | NC |
| Zip Code | 27536-2927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841295904 | Henderson Emergency Physicians, Pllc | Emergency Medicine | 566 Ruin Creek Rd, Henderson Emergency Physicians, Henderson, NC 27536-2927 | 2005-06-16 |
| 1639777212 | Clarissa Stephens | Nurse Practitioner | 566 Ruin Creek Rd, Henderson, NC 27536-2927 | 2020-10-15 |
| 1447857016 | Victoria Mccloskey | Occupational Therapist | 566 Ruin Creek Rd, Henderson, NC 27536-2927 | 2020-10-06 |
| 1649883190 | Gloria Eun-sun Chun | Physician Assistant | 566 Ruin Creek Rd, Henderson, NC 27536-5932 | 2020-08-25 |
| 1386270460 | Jacob Keith Poe | Nurse Anesthetist, Certified Registered | 566 Ruin Creek Rd, Henderson, NC 27536-2927 | 2020-03-20 |
| 1821554643 | Claudia Kostich | Specialist/Technologist | 566 Ruin Creek Rd, Henderson, NC 27536-2927 | 2019-02-17 |
| 1407312424 | Kevin Austin Rapp | Physician Assistant | 566 Ruin Creek Rd, Henderson, NC 27536-2927 | 2019-02-14 |
| 1265905780 | Shakiera Whyte | Nurse Practitioner | 566 Ruin Creek Rd, Henderson, NC 27536-2927 | 2019-01-08 |
| 1174006902 | Dlp Maria Parham Physician Practices LLC | Physician Assistant | 566 Ruin Creek Rd, Henderson, NC 27536-2927 | 2018-09-07 |
| 1083197818 | Dlp Maria Parham Physician Practices LLC | Surgery | 566 Ruin Creek Rd, Henderson, NC 27536-2927 | 2018-09-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952940926 | Lane and Associates Xxxvi Dds Pa | Dentist | 900 South Garnett St., Henderson, NC 27536 | 2019-12-23 |
| 1487012076 | Melissa Burroughs | Registered Nurse | 943-h W. Andrews Avenue, Henderson, NC 27536 | 2016-02-10 |
| 1578949269 | Growth Recovery Opportunity & Wellness | Community/Behavioral Health | 804 South Garnett St, Henderson, NC 27536 | 2015-08-04 |
| 1003290297 | Saintpaulhealthcarept, Inc. | Home Health | 839 E Montgomery St, Henderson, NC 27536 | 2015-07-17 |
| 1518369859 | Kristina Thornton | Pharmacist | 200 North Cooper Road, Henderson, NC 27536 | 2014-09-18 |
| 1306285135 | Green Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 429 Sunnyview Road, Henderson, NC 27536 | 2013-06-14 |
| 1760820278 | Innovative Health Services | In Home Supportive Care | 1758 Parham Street, Henderson, NC 27536 | 2013-06-06 |
| 1578900015 | Frances Veronica Finamore | Counselor | 710 Parham Street, Henderson, NC 27536 | 2013-05-23 |
| 1952530834 | Sucessful Achievements Program Incorporated | Driver | 133 Us 1 A, Norlina, NC 27536 | 2009-07-13 |
| 1407096100 | Recovery Response Center | Psychiatric Hospital | 300 Parkview Drive, Henderson, NC 27536 | 2009-02-20 |
| Find all providers in zip 27536 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396856506 | Arshad Iftekhar Husain | Internal Medicine | 110 N Water St, Henderson, KY 42420-3142 | 2006-08-31 |
| 1972512390 | Paul Michael | Internal Medicine | 199 Courtney Ann Dr, Henderson, NV 89074 | 2006-08-05 |
| 1083611362 | Edgardo Averion Faylona | Internal Medicine | 58 N Pecos Rd, Henderson, NV 89074-7319 | 2005-07-01 |
| 1295732808 | Hyo-jong Park | Internal Medicine | 2460 W Horizon Ridge Pkwy, Henderson, NV 89052-2648 | 2005-06-29 |
| 1699772210 | Russell Patrick Gollard | Internal Medicine | 3175 Saint Rose Pkwy Fl 2, Henderson, NV 89052-3506 | 2005-06-29 |
| 1235136854 | Gilbert Mudiwa Nyamuswa | Internal Medicine | 10001 S Eastern Ave Ste 301, Henderson, NV 89052 | 2005-06-29 |
| 1538561865 | Dlp Maria Parham Physician Practices, LLC | Internal Medicine | 120 Charles Rollins Rd, Suite 206, Henderson, NC 27536-2882 | 2014-09-18 |
| 1972892750 | Jacqueline Malekirad | Internal Medicine | 3175 Saint Rose Pkwy Fl 2, Henderson, NV 89052 | 2011-04-01 |
| 1285869727 | Stephani Dawn Christensen | Internal Medicine | 1505 Wigwam Pkwy Ste 130, Henderson, NV 89074-8195 | 2009-05-28 |
| 1487819421 | New Hope Blood and Cancer Center | Internal Medicine | 110 N Water St, Henderson, KY 42420-3142 | 2008-07-18 |
| Find all providers in HENDERSON | ||||
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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.