PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1801126537) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801126537 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | DUKE FERTILITY CLINIC |
| Practice Address |
5704 Fayetteville Rd Durham NC 27713-9089 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9196848111 |
| Mailing Telephone | 9196848111 |
| Enumeration Date | 2009-12-31 |
| Last Update Date | 2011-12-09 |
| Authorized Official Name | MR. MARK L CANTRELL (CHIEF PRIVACY & COMPLIANCE OFFICER) |
| Authorized Official Telephone | 8186685161 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Duke Fertility Clinic | 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 |
5704 FAYETTEVILLE RD |
| City | DURHAM |
| State | NC |
| Zip Code | 27713-9089 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033183314 | Karen Christine Baker | Urology | 5704 Fayetteville Rd, Durham, NC 27713-9089 | 2006-02-14 |
| 1629269873 | Duke University | Specialist | 5704 Fayetteville Rd, Durham, NC 27713-9089 | 2007-08-05 |
| 1821119074 | Jennifer L Eaton | Obstetrics & Gynecology | 5704 Fayetteville Rd, Durham, NC 27713-9089 | 2007-04-03 |
| 1154405025 | David Walmer | Obstetrics & Gynecology | 5704 Fayetteville Rd, Durham, NC 27713-9089 | 2006-10-25 |
| 1790869683 | Thomas Price | Obstetrics & Gynecology | 5704 Fayetteville Rd, Duke Fertility Center, Durham, NC 27713-9089 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558977074 | Zoe Wellness | Clinic/Center | 5322 Nc 55, 102, Durham, NC 27713 | 2020-09-21 |
| 1194352542 | Mariah Davis | Counselor | 1822 East Hwy Nc 54, Suite 300, Durham, NC 27713 | 2020-03-25 |
| 1316589138 | Monarch | Community/Behavioral Health | 1513 Piperwood Court, Durham, NC 27713 | 2019-10-14 |
| 1205486081 | Lisa Mesmer Barnes | Nurse Practitioner | 5309hwy 55, Suite 105, Durham, NC 27713 | 2019-09-13 |
| 1497315352 | Mary Therese Wood | Social Worker | 1822 E Highway 54, Suite 300, Durham, NC 27713 | 2019-06-13 |
| 1720558307 | Kevin D Simmons | Counselor | 1822 Nc Hwy 54 Suite 300, Durham, NC 27713 | 2018-11-27 |
| 1790265585 | Kelli Cryer | Counselor | 54 E Nc Hwy 1822, Suite 300, Durham, NC 27713 | 2018-08-21 |
| 1477039253 | Mahavir Rx, LLC | Pharmacy | 6216 Fayetteville Rd Ste 105, Durham, NC 27713 | 2018-07-16 |
| 1811482862 | Tessa Taylor | Dentist | 2515 E Nc Highway 54 Ste 2000, Durham, NC 27713 | 2018-06-22 |
| 1013401579 | Emily Louise Haller | Counselor | 1822 E Hwy 54, Suite 300, Durham, NC 27713 | 2018-06-19 |
| Find all providers in zip 27713 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194144063 | Jordan Enns Schaumberg | Obstetrics & Gynecology | 5324 Mcfarland Rd Ste 300, Durham, NC 27707-6864 | 2014-04-08 |
| 1710253349 | Latoya Patterson | Obstetrics & Gynecology | 1602 Harrier Ct, Durham, NC 27713-9100 | 2012-03-28 |
| 1396986279 | John Harrison Baker | Obstetrics & Gynecology | 400 Crutchfield Street, Ste. B, Durham, NC 27704 | 2009-03-23 |
| 1730344417 | Dmitry Fridman | Obstetrics & Gynecology | 40 Duke Medicine Cir Dept Of, Durham, NC 27710-4000 | 2008-07-22 |
| 1417136508 | Lynda B Mchutchison | Obstetrics & Gynecology | 5309 Highgate Dr, Durham, NC 27713-8501 | 2007-10-25 |
| 1912199126 | Beverly Allen Gray | Obstetrics & Gynecology | 203 Baker House, Durham, NC 27710-0001 | 2007-08-11 |
| 1043418163 | Ryan Timothy Bakelaar | Obstetrics & Gynecology | 122 Eagles Nest Dr, Durham, NC 27712-2989 | 2007-07-10 |
| 1760692313 | Amy Nicole Broach | Obstetrics & Gynecology | Po Box Office, Box 3609, Durham, NC 27710-0001 | 2007-05-23 |
| 1720115827 | Jennifer E Norten | Obstetrics & Gynecology | Dumc 3119, Durham, NC 27710-0001 | 2007-02-27 |
| 1558425272 | Shelley Rice | Obstetrics & Gynecology | 40 Medicine Circle Blue Zone Room 3688, Durham, NC 27710-0001 | 2006-12-20 |
| Find all providers in DURHAM | ||||
Please comment or provide details below to improve the information on PRIVATE DIAGNOSTIC CLINIC, PLLC.
| 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.