PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1417407545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417407545 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | DUKE ORTHOPAEDICS OF RALEIGH |
| Practice Address |
3480 Wake Forest Rd Suite 204 Raleigh NC 27609-7376 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9198625093 |
| Practice Fax Number | 9198625605 |
| Mailing Telephone | 9196848111 |
| Mailing Fax Number | 9196204921 |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2016-11-01 |
| Authorized Official Name | C T FREDERICK (PRACTICE CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9196201055 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Other Name | Type Code |
|---|---|
| Duke Orthopaedics of Raleigh | 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 |
3480 WAKE FOREST RD SUITE 204 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27609-7376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659342806 | Philip A Davenport | Psychiatry & Neurology | 3480 Wake Forest Rd, Suite 502, Raleigh, NC 27609-7376 | 2006-01-27 |
| 1275084782 | Megan Ashley Keesee | Dietitian, Registered | 3480 Wake Forest Rd, Medical Office Building 8 Suite 520, Raleigh, NC 27609-7376 | 2016-10-19 |
| 1235686098 | Mackenzie Patterson | Physician Assistant | 3480 Wake Forest Rd, Suite 204, Raleigh, NC 27609-7376 | 2016-09-08 |
| 1184031825 | Kensi Cobb Saia | Audiologist | 3480 Wake Forest Rd, Raleigh, NC 27609 | 2014-07-15 |
| 1255764403 | Melissa Cathleen Ginesi | Audiologist | 3480 Wake Forest Rd, Suite 404, Raleigh, NC 27609-7376 | 2013-08-12 |
| 1134465586 | Jessica Renee Jones | Physician Assistant | 3480 Wake Forest Rd, Suite 414, Raleigh, NC 27609-7376 | 2012-12-12 |
| 1437410826 | Holli Leigh Rehm | Audiologist | 3480 Wake Forest Rd, Suite 404, Raleigh, NC 27609-7376 | 2012-06-03 |
| 1902176993 | Ashley Rosann Haskin | Physician Assistant | 3480 Wake Forest Rd, Suite 414, Raleigh, NC 27609-7376 | 2012-01-06 |
| 1497034177 | Emily Louise Scheuring | Speech-Language Pathologist | 3480 Wake Forest Rd, Suite 404, Raleigh, NC 27609-7376 | 2011-08-11 |
| 1821389099 | Private Diagnostic Clinic, Pllc | Pain Medicine | 3480 Wake Forest Rd, Suite 208, Raleigh, NC 27609-7376 | 2011-04-22 |
| 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 | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720529514 | Lovely Hair Solutions | Prosthetic/Orthotic Supplier | 4701 Atlantic Ave, Raleigh, NC 27604-8108 | 2017-03-14 |
| 1316217359 | Del Bianco Enterprises | Prosthetic/Orthotic Supplier | 3320 Executive Dr Ste 210, Raleigh, NC 27609-7445 | 2012-01-09 |
| 1710275417 | Body Supports Unlimited LLC | Prosthetic/Orthotic Supplier | 2231 E Millbrook Rd, Suite 101, Raleigh, NC 27604-1746 | 2011-07-14 |
| 1902100159 | Cdo Foot Solutions Raleigh, Inc. | Prosthetic/Orthotic Supplier | 8531 Brier Creek Pkwy Ste 113, Raleigh, NC 27617-2005 | 2011-01-03 |
| 1750614954 | Romanus U Ani | Prosthetic/Orthotic Supplier | 4909 Alpinis Dr., Suite 101, Raleigh, NC 27616-1852 | 2009-09-08 |
| 1205042678 | Bio-tech Prosthetics and Orthotics of Raleigh | Prosthetic/Orthotic Supplier | 3909 Sunset Ridge Rd Ste 103, Raleigh, NC 27607-6668 | 2007-05-15 |
| 1073661351 | Cristina Sehestedt | Prosthetic/Orthotic Supplier | 5105 Moss Hill Dr, Raleigh, NC 27616-7883 | 2007-01-05 |
| 1346315553 | North Carolina Orthotics & Prosthetics R | Prosthetic/Orthotic Supplier | 8451 Garvey Dr, Suite 108, Raleigh, NC 27616-3355 | 2006-11-22 |
| 1285740894 | Professional Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 5300 Atlantic Ave, Suite 101, Raleigh, NC 27609-1122 | 2006-08-23 |
| 1508820887 | Orthopedic Service Co of Raleigh,inc | Prosthetic/Orthotic Supplier | 2521 Noblin Rd, Raleigh, NC 27604-2415 | 2006-04-14 |
| Find all providers in RALEIGH | ||||
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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.