PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1477785814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477785814 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | DUKE SPECIALTY CLINIC KNIGHTDALE |
| Practice Address |
162 Legacy Oaks Dr Hwy 64 and I-540 Kinghtdal NC 27545-6501 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9196848111 |
| Mailing Telephone | 9196848111 |
| Enumeration Date | 2009-08-19 |
| Last Update Date | 2011-12-08 |
| Authorized Official Name | MR. MARK L CANTRELL (CHIEF PRIVACY & COMPLIANCE OFFICER) |
| Authorized Official Telephone | 9196685161 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Duke Specialty Clinic Knightdale | 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 |
162 LEGACY OAKS DR HWY 64 AND I-540 |
| City | KINGHTDAL |
| State | NC |
| Zip Code | 27545-6501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639688526 | Galberth Health | Physical Therapist | 8002 Peachtree Town Ln, Knightdale, NC 27545 | 2017-09-24 |
| 1790215390 | Edward Hoggard Jr. | Counselor | 2013 Ballston Place, Knightdale, NC 27545 | 2017-06-15 |
| 1730635970 | Tara Forsythe | Social Worker | 4006 Peachtree Town Lane, Knightdale, NC 27545 | 2016-08-28 |
| 1134504962 | Maybell Grino | Pharmacist | 7201 Us Highway 64, Knightdale, NC 27545 | 2015-07-22 |
| 1477948735 | Q1 Clinical Consultants, LLC | Community/Behavioral Health | 1408 Silver Valley Dr, Knightdale, NC 27545 | 2015-04-03 |
| 1235560772 | Shameka Latoya Davis | Counselor | 7417 Knightdale Blvd Unit 101, Knightdale, NC 27545 | 2013-12-10 |
| 1992135107 | Daniel Ross Conti | Dentist | 1001 Widewaters Parkway, Knightdale, NC 27545 | 2013-11-25 |
| 1255773644 | David D Sanjurjo | Nurse Practitioner | 7201 Us Hwy 64, Knightdale, NC 27545 | 2013-07-25 |
| 1790037133 | Dona D Mayo | Counselor | 502 Mcknight Drive, Better Communities, Knightdale, NC 27545 | 2012-10-09 |
| 1699972257 | Lindsay Horwat | Occupational Therapist | 1010 Emerald Common Drive, Apartment 205, Knightdale, NC 27545 | 2007-06-28 |
| Find all providers in zip 27545 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124657663 | Cardiosleep Diagnostics | Internal Medicine | 1862 Old Fort Rd, Greenville, NC 27834-9373 | 2020-04-06 |
| 1619467529 | Clerio Francisco De Azevedo Filho | Internal Medicine | 10 Medicine Circle - Duke Medical Pavilion Room 1e50, Durham, NC 27710-0001 | 2018-05-16 |
| 1700385846 | The Presbyterian Hospital | Internal Medicine | 1918 Randolph Rd Ste 820, Charlotte, NC 28207-1119 | 2018-02-05 |
| 1841713187 | Wake Specialty Physicians LLC | Internal Medicine | 3000 New Bern Ave Ste 1200, Raleigh, NC 27610-1231 | 2017-07-19 |
| 1225563463 | Benjamin Mcginty Chilcutt | Internal Medicine | 300 Meadowmont Village Cir Ste 104, Chapel Hill, NC 27517-7518 | 2017-04-25 |
| 1437517182 | Regional Physicians LLC | Internal Medicine | 103 W Center St, Lexington, NC 27292 | 2016-02-09 |
| 1982069928 | Four Jewels Healthways | Internal Medicine | 320 Lillington Ave Ste 201, Charlotte, NC 28204-3189 | 2015-12-17 |
| 1932505294 | Donald Frederick Fortin | Internal Medicine | 14001 Weston Pkwy, Suite 101, Cary, NC 27513-2255 | 2014-11-14 |
| 1538564232 | Forsyth Memorial Hospital, Inc | Internal Medicine | 694 Riverside Drive, Mt. Airy, NC 27030-3117 | 2014-10-24 |
| 1710382411 | Forsyth Memorial Hospital, Inc | Internal Medicine | 7114 Villiage Medical Circle, Clemmons, NC 27012 | 2014-10-24 |
| Find all providers with the same taxonomy | ||||
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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.