PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1306116611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306116611 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | CAROLINA WOMEN'S HEALTH |
| Practice Address |
3404 Wake Forest Rd Suite 200 Raleigh NC 27609-7340 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9192350097 |
| Mailing Telephone | 9196848111 |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |
| Authorized Official Name | MR. MARK L CANTRELL (CHIEF COMPLIANCE & PRIVACY OFFICER) |
| Authorized Official Telephone | 9196848111 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Carolina Women's Health | 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 |
3404 WAKE FOREST RD SUITE 200 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27609-7340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467455832 | Jon Kolkin | Orthopaedic Surgery | 3404 Wake Forest Rd, Ste 303, Raleigh, NC 27609-7341 | 2005-05-31 |
| 1891283073 | Regional Anesthesia, Pllc | Specialist | 3404 Wake Forest Rd, Raleigh, NC 27609-7340 | 2018-04-24 |
| 1023517745 | Melissa Jo Peterson | Nurse Practitioner | 3404 Wake Forest Rd, Raleigh, NC 27609-7340 | 2018-02-08 |
| 1972054211 | Claire Gere Reynolds | Nurse Practitioner | 3404 Wake Forest Rd, 202, Raleigh, NC 27609-7340 | 2016-10-21 |
| 1477920247 | Jaclyn White | Nurse Practitioner | 3404 Wake Forest Rd, Suite 302, Raleigh, NC 27609-7340 | 2015-08-27 |
| 1790160745 | Catherine Frances Sellers | Nurse Practitioner | 3404 Wake Forest Rd, Mob 7, Lower Level, Raleigh, NC 27609-7340 | 2015-07-20 |
| 1093057028 | Stephanie Nicole Roberts | Registered Nurse | 3404 Wake Forest Rd, St 200, Raleigh, NC 27609-7340 | 2013-03-15 |
| 1942558705 | Meaghan Thomas | Occupational Therapy Assistant | 3404 Wake Forest Rd, Suite 303, Raleigh, NC 27609-7340 | 2012-08-27 |
| 1477834349 | Brittaney Swift Wolfe | Nurse Practitioner | 3404 Wake Forest Rd, Suite 203, Raleigh, NC 27609-7340 | 2011-09-06 |
| 1154654531 | Private Diagnostic Clinic, Pllc | Surgery | 3404 Wake Forest Rd, Suite 101, Raleigh, NC 27609-7340 | 2009-09-16 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 27609 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972142727 | The Whole Woman, Pllc | Obstetrics & Gynecology | 7509 Six Forks Rd Ste 101, Raleigh, NC 27615-5020 | 2019-12-26 |
| 1639696149 | Raleigh Gynecology & Wellness, Pa | Obstetrics & Gynecology | 2304 Wesvill Ct Ste 210, Raleigh, NC 27607-2973 | 2017-08-25 |
| 1477963874 | Kathryn Elizabeth Barletta | Obstetrics & Gynecology | 4325 Lake Boone Trl Ste 315, Raleigh, NC 27607 | 2014-05-07 |
| 1750708848 | Woman To Woman Gynecology Pllc | Obstetrics & Gynecology | 3909 Sunset Ridge Rd Ste 201, Raleigh, NC 27607-6668 | 2014-03-26 |
| 1023220522 | Andrew John Cracker | Obstetrics & Gynecology | 1604 Jones Franklin Road, Raleigh, NC 27606 | 2007-05-04 |
| 1437287075 | Charlotte A Sweeney | Obstetrics & Gynecology | 2825 Exeter Cir, Raleigh, NC 27608-1115 | 2007-03-02 |
| 1497805584 | Jouko K Halme | Obstetrics & Gynecology | 3305 Drake Cir, Raleigh, NC 27607-3332 | 2007-01-11 |
| 1205996998 | Nicole P Kerner | Obstetrics & Gynecology | 9212 Duncanshire Ct, Raleigh, NC 27613-5483 | 2006-12-11 |
| 1396849998 | Bruce Elliott Norman | Obstetrics & Gynecology | 111 N Bloodworth St, Raleigh, NC 27601-1103 | 2006-09-12 |
| 1790898138 | Tracy H Lathrop | Obstetrics & Gynecology | 8300 Health Park Ste 320, Raleigh, NC 27615-4731 | 2006-08-17 |
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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.