PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1821389099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821389099 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | PIEDMONT SPINE SPECIALISTS, PA |
| Practice Address |
3480 Wake Forest Rd Suite 208 Raleigh NC 27609-7376 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9197814541 |
| Practice Fax Number | 9197814541 |
| Mailing Telephone | 9196848111 |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2011-12-09 |
| 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 | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Piedmont Spine Specialists, PA | 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 208 |
| 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 | 208VP0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Pain Medicine |
| Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient’s pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies. |
| Notes: Source: American Academy of Pain Medicine, www.painmed.org - Additional Resources:The American Board of Pain Medicine provides Board Certification. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972828457 | Laurence Sidney Holman | Pain Medicine | 10880 Durant Rd Ste 324, Raleigh, NC 27614-6629 | 2010-03-29 |
| 1548298334 | Jon Jay Wilson | Pain Medicine | 3480 Wake Forest Rd, Suite 208, Raleigh, NC 27609-7376 | 2006-06-29 |
| 1780628198 | John Gregory Bentley | Pain Medicine | 3948 Browning Pl, Suite 109, Raleigh, NC 27609-6510 | 2006-06-15 |
| 1720028558 | Piedmont Spine Specialists, Pa | Pain Medicine | 3480 Wake Forest Rd, Suite 208, Raleigh, NC 27609-7376 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790305241 | Carolinas Pain Institute, Pa | Pain Medicine | 330 Billingsley Rd Ste 210, Charlotte, NC 28211-5055 | 2020-04-24 |
| 1841767225 | Comprehensive Pain Consultants of The Carolinas, Pllc | Pain Medicine | 108 Monticello Rd, Weaverville, NC 28787-8936 | 2018-10-24 |
| 1972085918 | Dynamic Health Medical Group Pllc | Pain Medicine | 4705 South Blvd, Charlotte, NC 28217 | 2018-09-06 |
| 1891151726 | Latoya Long-gregory | Pain Medicine | 108 S Main St Ste F, Davidson, NC 28036-8096 | 2016-01-07 |
| 1154485977 | Veronica L Alston | Pain Medicine | Joel Health Clinic Bldg 4851, Fort Bragg, NC 28310-0001 | 2006-12-20 |
| 1407860638 | Miles D Hyman | Pain Medicine | 1018 E Main St, Franklin, NC 28734-2676 | 2006-07-27 |
| 1689627200 | Aaron H Gootman | Pain Medicine | 1840 Owen Dr, Fayetteville, NC 28304-1633 | 2006-05-17 |
| 1275511966 | Mark Lucas Phillips | Pain Medicine | 522 N Elam Ave, Ste 203, Greensboro, NC 27403-1151 | 2006-01-04 |
| 1275510570 | David Spivey | Pain Medicine | 2912 Maplewood Ave, Winston-salem, NC 27103-1507 | 2005-12-28 |
| 1326033879 | Steven K Brockman | Pain Medicine | 1112 Yancey St, Shelby, NC 28150-3672 | 2005-09-12 |
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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.