PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1659304848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659304848 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | DUKE HEALTH CENTER OF SMITHFIELD |
| Practice Address |
507 N Brightleaf Blvd Suite 100 Smithfield NC 27577-4405 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9196848111 |
| Mailing Telephone | 9196848111 |
| Enumeration Date | 2006-07-09 |
| 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 | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 790174U | 05 | |
| NC | GRP | 0174U | 01 |
| TRICARE GRP | 1029437033 | 01 |
| Other Name | Type Code |
|---|---|
| Duke Health Center of Smithfield | 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 |
507 N BRIGHTLEAF BLVD SUITE 100 |
| City | SMITHFIELD |
| State | NC |
| Zip Code | 27577-4405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528404415 | Johnston Specialty Physician Services, Inc. | Neuromusculoskeletal Medicine & OMM | 507 N Brightleaf Blvd, Suite 100, Smithfield, NC 27577-4405 | 2013-05-17 |
| 1649411505 | William Hawkins | Physician Assistant | 507 N Brightleaf Blvd, Suite 100, Smithfield, NC 27577-4405 | 2009-03-23 |
| 1720224157 | Amanda Jo-lynne Pollard | Physician Assistant | 507 N Brightleaf Blvd, Suite 209, Smithfield, NC 27577-4405 | 2009-01-07 |
| 1235304825 | James Alexis Macdonald Jr. | Psychiatry & Neurology | 507 N Brightleaf Blvd, Suite 100, Smithfield, NC 27577-4405 | 2008-04-24 |
| 1407039324 | Tri County Community Health Council Inc | Clinic/Center | 507 N Brightleaf Blvd, Suite 209, Smithfield, NC 27577-4405 | 2007-12-13 |
| 1184815581 | Johnston Memorial Hospital Authority | Internal Medicine | 507 N Brightleaf Blvd, Suite 201 Medical Arts Bldg, Smithfield, NC 27577-4405 | 2007-08-09 |
| 1447478771 | Mohamed & Associates Urology Center, Pa | Registered Nurse | 507 N Brightleaf Blvd, Suite 205, Smithfield, NC 27577-4405 | 2007-04-23 |
| 1194869537 | Robert G Lippitt | Urology | 507 N Brightleaf Blvd, Suite 205, Smithfield, NC 27577-4405 | 2007-02-19 |
| 1750425195 | Adel W Mohamed | Urology | 507 N Brightleaf Blvd, Suite 205, Smithfield, NC 27577 | 2007-02-19 |
| 1932125432 | Private Diagnostic Clinic, Pllc | Orthopaedic Surgery | 507 N Brightleaf Blvd, Suite 100, Smithfield, NC 27577-4405 | 2006-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851919047 | Sherwin Cuaresma Bernardino | Physical Therapist | Meadowview Assisted Living Center, 250 Nc-210, Smithfield, NC 27577 | 2020-07-14 |
| 1386297299 | Johnston Opco, LLC | Non-emergency Medical Transport (VAN) | 200 Kellie Dr, Smithfield, NC 27577 | 2019-07-19 |
| 1790255362 | Adrian Brook Taylor | Physical Therapist | 540 North Street, Smithfield, NC 27577 | 2018-11-27 |
| 1497260608 | Providence Healthcare of The Carolinas | Assisted Living Facility | 4302 Hwy Nc 210, Smithfield, NC 27577 | 2017-12-11 |
| 1720593908 | Latorya Delois Moore | Nurse Practitioner | 514 N Brightleaf Blvd Ste 1100, Smithfield, NC 27577 | 2017-12-09 |
| 1124546171 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 104 N Brightleaf Blvd, Smithfield, NC 27577 | 2017-08-30 |
| 1316482201 | Providence Pain, Spine & Recovery, Pllc | Anesthesiology | 7 Berkshire Rd, Smithfield, NC 27577 | 2016-12-30 |
| 1407203318 | Linda Pearl Trujillo | Early Intervention Provider Agency | 623 Tralee Dr, Smithfield, NC 27577 | 2016-05-20 |
| 1336500206 | Saundra Casey | Counselor | 15 Noble Street, Smithfield, NC 27577 | 2016-03-18 |
| 1639537707 | Ralph Edwin Wilson Jr. | Physician Assistant | 100 Kellie Drive, Smithfield, NC 27577 | 2016-02-04 |
| Find all providers in zip 27577 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1780979286 | Urgent Care of Smithfield, Pa | Internal Medicine | 388 Venture Dr Ste I, Smithfield, NC 27577-4775 | 2011-06-13 |
| 1396973996 | Mir M Ali | Internal Medicine | 706 Wilkins St, Ste C, Smithfield, NC 27577-4662 | 2009-06-23 |
| 1457400467 | Christian Donohue | Internal Medicine | 507 N Brightleaf Blvd Ste 100, Smithfield, NC 27577-4405 | 2007-01-09 |
| 1295813400 | Abm Enayet Ullah | Internal Medicine | 706 Wilkins St Ste C, Smithfield, NC 27577-4662 | 2006-11-02 |
| 1639287089 | Woodrow Batten | Internal Medicine | 720 Sunset Drive, Smithfield, NC 27577 | 2006-08-27 |
| 1689685042 | John Michael Corsi | Internal Medicine | 28 Cedar Swamp Rd, Smithfield, RI 02917 | 2006-08-11 |
| 1740214048 | Shubi Shahida, Md, PC | Internal Medicine | 712-a Wilkins Street, Smithfield, NC 27577-4664 | 2006-07-10 |
| 1629019815 | Edwin L Hartman | Internal Medicine | 388 I Venture Dr., Smithfield, NC 27577-3841 | 2006-06-09 |
| 1558342733 | Shannon M Pope | Internal Medicine | 201 Gumwood Dr, Smithfield, VA 23430-6086 | 2005-11-07 |
| 1780682484 | Eric Michael Janis | Internal Medicine | 910 Berkshire Rd, Smithfield, NC 27577-4751 | 2005-07-07 |
| Find all providers in SMITHFIELD | ||||
| City | SMITHFIELD |
| Zip Code | 27577 |
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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.