PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1700087194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700087194 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | DUKE GASTROENTEROLOGY OF RALEIGH |
| Practice Address |
3480 Wake Forest Rd Suite 500 Raleigh NC 27609-7376 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9198625075 |
| Mailing Telephone | 9196848111 |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-07 |
| 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 | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Duke Gastroenterology 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 500 |
| 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 |
| 1417407545 | Private Diagnostic Clinic, Pllc | Orthopaedic Surgery | 3480 Wake Forest Rd, Suite 204, Raleigh, NC 27609-7376 | 2016-10-13 |
| 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 |
| 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 | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal 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 |
|---|---|---|---|---|
| 1730400268 | Amit Patel | Internal Medicine | 10207 Cerny St Ste 210, Raleigh, NC 27617-4887 | 2010-06-18 |
| 1811049307 | John V Yacono | Internal Medicine | 1011 Dresser Ct, Raleigh, NC 27609-7323 | 2007-01-17 |
| 1780778548 | Anant B Soni Md Pa | Internal Medicine | 3124 Blue Ridge Rd Ste 103, Raleigh, NC 27612-8041 | 2006-10-03 |
| 1750348769 | Sharif Riaz Chowdhury | Internal Medicine | 3024 New Bern Avenue, Suite 301, Raleigh, NC 27610 | 2006-04-26 |
| 1518968775 | Seth A Kaplan | Internal Medicine | 3100 Blue Ridge Rd, Suite 300, Raleigh, NC 27612-8036 | 2005-08-09 |
| 1073519880 | Ruth Mokeba-ekangaki | Internal Medicine | 2417 Atrium Dr, Suite 150, Raleigh, NC 27607-6673 | 2005-06-27 |
| 1356906705 | Wakemed Specialists Group, LLC | Internal Medicine | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-01 |
| 1588227839 | Wakemed Specialists Group, LLC | Internal Medicine | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2019-04-22 |
| 1033679774 | Molly Whittaker Mcelroy | Internal Medicine | 3100 Blue Ridge Rd Ste 300, Raleigh, NC 27612-8002 | 2019-03-20 |
| 1487139929 | Raleigh D Eckert | Internal Medicine | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2018-10-01 |
| 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.