PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1841216348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841216348 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | DUKE THORACIC SURGERY OF RALEIGH |
| Practice Address |
3480 Wake Forest Rd Suite 512 Raleigh NC 27609-7376 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9198625970 |
| Mailing Telephone | 9196848111 |
| Enumeration Date | 2006-07-15 |
| 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 | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS GROUP NUMBER | 018FY | 01 |
| NC | 5904173 | 05 |
| Other Name | Type Code |
|---|---|
| Duke Thoracic Surgery 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 512 |
| 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 |
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| 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 | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144884636 | Wakemed Specialists Group, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2019-04-30 |
| 1326316704 | Rex Hospital Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4420 Lake Boone Trl, Suite 100, Raleigh, NC 27607-7505 | 2011-12-13 |
| 1871878470 | Rex Hospital Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2800 Blue Ridge Rd, Suite 201, Raleigh, NC 27607-6478 | 2011-10-14 |
| 1710213160 | Rex Physicians LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2800 Blue Ridge Road, Suite 403, Raleigh, NC 27607-6476 | 2009-10-20 |
| 1306040266 | Richard Marston Gillespie | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2800 Blue Ridge Rd, Suite 201, Raleigh, NC 27607-6478 | 2007-06-13 |
| 1497966782 | Bryon Boulton | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3000 New Bern Ave, Suite 1100, Raleigh, NC 27610-1231 | 2007-05-25 |
| 1902930720 | Capital Cardiovascular Surgery Pa | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3214 Charles B Root Wynd, 203, Raleigh, NC 27612-5440 | 2007-03-15 |
| 1437257250 | Lance Eric Landvater | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3000 New Bern Ave Ste 1100, Raleigh, NC 27610 | 2006-09-20 |
| 1891705240 | Alvan W Atkinson | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3214 Charles B Root Wynd, Suite 203, Raleigh, NC 27612-5440 | 2006-08-08 |
| 1154339034 | Robert Merrill Hunter | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3000 New Bern Ave, Suite 1100, Raleigh, NC 27610 | 2006-08-04 |
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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.