PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1437400280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437400280 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | CAROLINA FAMILY PRACTICE & SPORTS MEDICINE-CARY |
| Practice Address |
3700 Nw Cary Pkwy Ste. 110 Cary NC 27513-8446 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9192382000 |
| Mailing Telephone | 9196848111 |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2012-09-19 |
| Authorized Official Name | VALLA F WILSON (CHIEF COMPLIANCE PRIVACY & AUDIT OF) |
| Authorized Official Telephone | 9196685161 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Carolina Family Practice & Sports Medicine-Cary | 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 |
3700 NW CARY PKWY STE. 110 |
| City | CARY |
| State | NC |
| Zip Code | 27513-8446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477543049 | Laura Elizabeth Hudak | Physical Therapist | 3700 Nw Cary Pkwy, Suite 110, Cary, NC 27513-8446 | 2005-10-25 |
| 1912448366 | Julie Davison Phillippi | Specialist/Technologist | 3700 Nw Cary Pkwy, Cary, NC 27513-8446 | 2017-03-18 |
| 1780097618 | Duke University Health System Inc | Radiology | 3700 Nw Cary Pkwy, Suite 120 Room 120, Cary, NC 27513-8446 | 2014-06-09 |
| 1750701082 | Duke University Health System, Inc. | Radiology | 3700 Nw Cary Pkwy, Suite 120 Room 110, Cary, NC 27513-8446 | 2014-04-25 |
| 1134551807 | Patrick Thomas Ward | Physical Therapist | 3700 Nw Cary Pkwy, Suite 110, Cary, NC 27513-8446 | 2013-08-05 |
| 1942553219 | Hillary Hays Weissinger | Physician Assistant | 3700 Nw Cary Pkwy, Suite 110, Cary, NC 27513-8446 | 2012-10-23 |
| 1427326545 | Amanda Nicole Fitterer | Specialist/Technologist | 3700 Nw Cary Pkwy, Suite 110, Cary, NC 27513-8446 | 2011-12-03 |
| 1689960445 | James Richard Davis | Specialist/Technologist | 3700 Nw Cary Pkwy, Cary, NC 27513-8446 | 2011-06-21 |
| 1851600654 | Marci Elizabeth Siebeking | Physical Therapist | 3700 Nw Cary Pkwy, Suite 110, Cary, NC 27513-8446 | 2010-09-28 |
| 1639310295 | Cape Fear Diagnostic Imaging LLC | Radiology | 3700 Nw Cary Pkwy, Suite 120, Cary, NC 27513-8446 | 2009-03-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912525155 | Erikare At Home | In Home Supportive Care | 1750 Nw Maynard Road, Ste 100, Office 103, Cary, NC 27513 | 2020-07-13 |
| 1811527583 | Octavia Shada Allen | Behavior Technician | 15501 Western Parkway Suite 130, Cary, NC 27513 | 2020-01-22 |
| 1790249605 | Carolyn Ann Berlin | Nurse Practitioner | 3600 Northwest Cary Pkwy. Suite 104, Cary, NC 27513 | 2019-01-24 |
| 1346722550 | Wesley B Smith Dds Pa | Dentist | 130 Preston Executive Drive Suite 203, Cary, NC 27513 | 2018-09-04 |
| 1366920852 | Tsua Lor | Dentist | 3122 Lakeside View Ct, Cary, NC 27513 | 2018-08-06 |
| 1184133894 | Rebekah Lee Crisp | Occupational Therapist | Leagacy Healthcare Services At Searstone, 210 Walker Stone Drive, Cary, NC 27513 | 2017-09-26 |
| 1790203354 | Babies On The Move LLC | Physical Therapist | 100 Cavendish Dr, Cary, NC 27513 | 2017-09-05 |
| 1790157881 | Riccobene & Associates Xii, Dds, P.a. | Clinic/Center | 1203 Nw Maynard Road, Cary, NC 27513 | 2015-10-28 |
| 1508237413 | Riccobene & Associates Xv, Dds, P.a. | Clinic/Center | 1203 Northwest Maynard Road, Cary, NC 27513 | 2015-10-19 |
| 1104293356 | Katherine J Gooding | Audiologist-Hearing Aid Fitter | 301 Maynard Crossing Court, Cary, NC 27513 | 2015-08-24 |
| Find all providers in zip 27513 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| 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 Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720251044 | Novant Medical Group, Inc. | Family Medicine | 3700 Nw Cary Pkwy, Suite 110, Cary, NC 27513-8446 | 2008-04-08 |
| 1033160643 | Raleigh Durham Medical Group Pa | Family Medicine | 3700 Nw Cary Pkwy, Cary, NC 27513-8422 | 2006-05-16 |
| 1437144714 | Thomas Michael Howard | Family Medicine | 400 Ashville Ave, Suite 330, Cary, NC 27518-6134 | 2005-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255825410 | Novant Medical Group Inc. | Family Medicine | 15033 Balloncroft Parkway, Suite 200, Charlotte, NC 28277 | 2018-06-20 |
| 1760831028 | William M Sykes | Family Medicine | 129 T.t. Lanier St., Buies Creek, NC 27506 | 2016-06-08 |
| 1730561655 | Brendan Jay Michel | Family Medicine | 437 Little Fisher Trl, Mount Airy, NC 27030-6900 | 2015-06-27 |
| 1699179804 | Carolinas Physicians Network Inc | Family Medicine | 48380 Us Highway 52 N, Misenheimer, NC 28109 | 2014-10-17 |
| 1548509805 | Carolinas Physician Network, Inc. | Family Medicine | 332 North Trade Street, Suite 1200, Matthews, NC 28105-6566 | 2013-02-06 |
| 1699903211 | Robert Alcott | Family Medicine | 6050 W Highway 74, Ste D, Indian Trail, NC 28079-3591 | 2009-06-23 |
| 1962637926 | Thomas Joseph Thekkekandam | Family Medicine | 1635 Nc Highway 66 S, Suite 210, Kernersville, NC 27284-3854 | 2009-05-20 |
| 1477738714 | Forsyth Medical Group, LLC. | Family Medicine | 1900 S Hawthorne Rd Ste 480, Dba Sports Medicine Associates, Winston Salem, NC 27103-3913 | 2008-01-07 |
| 1396938171 | Lawrence M Linett, Md, Pllc | Family Medicine | 431 Western Blvd Ste E, Jacksonville, NC 28546-6823 | 2007-08-24 |
| 1962536516 | Richard T. Ferro | Family Medicine | 6832 Market St, Suite A, Wilmington, NC 28405-9723 | 2007-03-15 |
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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.