PRIVATE DIAGNOSTIC CLINIC, PLLC


Address: 10207 Cerny St Ste 306, Raleigh, NC 27617-4879
Phone: 9194052341

PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1083168181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083168181
Entity Type Organization
Organization Name PRIVATE DIAGNOSTIC CLINIC, PLLC
Other Organization Name BRIER CREEK NEPHROLOGY
Practice Address 10207 Cerny St Ste 306
Raleigh
NC 27617-4879
Mailing Address Po Box 63362
Charlotte
NC 28263-3362
Practice Telephone 9194052341
Practice Fax Number 9196609201
Mailing Telephone 9196204918
Enumeration Date 2016-08-08
Last Update Date 2016-08-08
Authorized Official Name CHRISTOPHER T FREDERICK (CFO)
Authorized Official Telephone 9196204918
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RN0300X Internal Medicine
Specialization: Nephrology
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Brier Creek Nephrology Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1538616289 Private Diagnostic Clinic, Pllc Neurological Surgery 1212 Cedarhurst Dr Ste 102, Raleigh, NC 27609-5588 2016-09-09
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
1770600363 Private Diagnostic Clinic, Pllc Internal Medicine 95 Springbrook Ave, Suite 111, Clayton, NC 27520-8520 2007-03-26

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities PRIVATE DIAGNOSTIC CLINIC, PLLC Duke University Medical Center, Durham, NC 27710-0001

Office Location

Street Address 10207 CERNY ST STE 306
City RALEIGH
State NC
Zip Code 27617-4879

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1962942326 Harris Teeter LLC Durable Medical Equipment & Medical Supplies 10440 Glenwood, Durham, NC 27617 2017-03-06
1457896037 Emergeortho Pa Durable Medical Equipment & Medical Supplies 7850 Brier Creek Parkway, Suites 200, Raleigh, NC 27617 2017-01-05
1033667621 Hillary Houghton Nurse Practitioner 10211 Alm St # 210, Raleigh, NC 27617 2016-09-13
1821449406 John William Langel Optometrist 8851 Ellstree Ln Ste 200, Raleigh, NC 27617 2016-06-24
1821457789 Acariahealth Pharmacy, Inc. Durable Medical Equipment & Medical Supplies 7231 Acc Blvd Ste 103, Raleigh, NC 27617 2016-02-19
1033583760 America Alisha Allen Social Worker 8610 Brittdale Lane, Apt 307, Raleigh, NC 27617 2015-11-18
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Taxonomy Information

Taxonomy Code 207RN0300X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Nephrology

Taxonomy Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1508360462 North Carolina Nephrology Pa Internal Medicine 3604 Bush St Fl 2, Raleigh, NC 27609-7511 2018-03-23
1104841436 Karn Gupta Internal Medicine 3604 Bush Street, Raleigh, NC 27609 2006-07-13
1932101177 Jeffrey Gordon Hoggard Internal Medicine 3031 New Bern Ave, Suite 100, Raleigh, NC 27610-1214 2005-06-01
1750835336 North Carolina Nephrology Pa Internal Medicine 3031 New Bern Ave, Suite 306, Raleigh, NC 27610-2989 2016-08-11
1699069948 Robert Edward Olivo Internal Medicine 3604 Bush St, Raleigh, NC 27609-7511 2011-06-03
1902087570 Libbie Parker Mckenzie Internal Medicine Central Prison, 1300 Western Blvd, Raleigh, NC 27606 2007-11-23
1295951036 So Yoon Jang Internal Medicine 3031 New Bern Ave, Ste. 306, Raleigh, NC 27610-2988 2007-04-18
1376769893 Adam Stern Internal Medicine 3031 New Bern Ave, Suite 306, Raleigh, NC 27610-2988 2007-04-17
1700971173 Eric Warren Raasch Internal Medicine 3031 New Bern Ave, Suite 306, Raleigh, NC 27610-2988 2006-10-03
1831129675 Capital Nephrology Associates, Pa Internal Medicine 3031 New Bern Ave, Ste 306, Raleigh, NC 27610-2989 2006-07-04
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City RALEIGH
Zip Code 27617

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Dataset Information

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.

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