PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1144246646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1144246646 |
Entity Type | Organization |
Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
Other Organization Name | DUKE HEMATOLOGY /ONCOLOGY @DUKE HEALTH RALEIGH HOSPITAL |
Practice Address |
3404 Wake Forest Rd Suite 100 Raleigh NC 27609-7340 |
Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
Practice Telephone | 9199543050 |
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 | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | BCBS GRP | 011GH | 01 |
NC | 89011GH | 05 |
Other Name | Type Code |
---|---|
Duke Hematology /Oncology @Duke Health Raleigh Hospital | 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 |
3404 WAKE FOREST RD SUITE 100 |
City | RALEIGH |
State | NC |
Zip Code | 27609-7340 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467455832 | Jon Kolkin | Orthopaedic Surgery | 3404 Wake Forest Rd, Ste 303, Raleigh, NC 27609-7341 | 2005-05-31 |
1891283073 | Regional Anesthesia, Pllc | Specialist | 3404 Wake Forest Rd, Raleigh, NC 27609-7340 | 2018-04-24 |
1023517745 | Melissa Jo Peterson | Nurse Practitioner | 3404 Wake Forest Rd, Raleigh, NC 27609-7340 | 2018-02-08 |
1972054211 | Claire Gere Reynolds | Nurse Practitioner | 3404 Wake Forest Rd, 202, Raleigh, NC 27609-7340 | 2016-10-21 |
1477920247 | Jaclyn White | Nurse Practitioner | 3404 Wake Forest Rd, Suite 302, Raleigh, NC 27609-7340 | 2015-08-27 |
1790160745 | Catherine Frances Sellers | Nurse Practitioner | 3404 Wake Forest Rd, Mob 7, Lower Level, Raleigh, NC 27609-7340 | 2015-07-20 |
1093057028 | Stephanie Nicole Roberts | Registered Nurse | 3404 Wake Forest Rd, St 200, Raleigh, NC 27609-7340 | 2013-03-15 |
1942558705 | Meaghan Thomas | Occupational Therapy Assistant | 3404 Wake Forest Rd, Suite 303, Raleigh, NC 27609-7340 | 2012-08-27 |
1306116611 | Private Diagnostic Clinic, Pllc | Obstetrics & Gynecology | 3404 Wake Forest Rd, Suite 200, Raleigh, NC 27609-7340 | 2012-01-03 |
1477834349 | Brittaney Swift Wolfe | Nurse Practitioner | 3404 Wake Forest Rd, Suite 203, Raleigh, NC 27609-7340 | 2011-09-06 |
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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 | 207RH0003X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Hematology & Oncology |
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760707707 | Robert Charles Shepard | Internal Medicine | 9124 White Eagle Ct, Raleigh, NC 27617-7438 | 2010-04-01 |
1467515247 | Michelle Schweitzer | Internal Medicine | 23 Sunnybrook Rd Ste 200, Raleigh, NC 27610-1855 | 2006-12-19 |
1902980873 | Sharon Taylor | Internal Medicine | 3404 Wake Forest Rd Ste 100, Raleigh, NC 27609-7341 | 2006-10-25 |
1245270784 | Henry L Cromartie | Internal Medicine | 2605 Blue Ridge Rd Ste 190, Raleigh, NC 27607 | 2006-06-06 |
1508813155 | Alan D Kritz | Internal Medicine | 4101 Macon Pond Dr, Raleigh, NC 27607-6319 | 2006-05-28 |
1063856284 | Vijay G Paryani | Internal Medicine | 4101 Macon Pond Rd, Raleigh, NC 27607-6319 | 2013-04-18 |
1164781415 | Anureet Cheema Copeland | Internal Medicine | 2605 Blue Ridge Rd Ste 190, Raleigh, NC 27607-6475 | 2012-05-08 |
1033411483 | Cancer Centers of North Carolina PC | Internal Medicine | 10010 Falls of Neuse Rd, Suite 203, Raleigh, NC 27614-8494 | 2010-11-17 |
1093744880 | Michael David Spiritos | Internal Medicine | 3404 Wake Forest Rd, Suite 202, Raleigh, NC 27609-7340 | 2006-07-02 |
1780624221 | Virgil L Rose Jr. | Internal Medicine | 4101 Macon Pond Rd, Raleigh, NC 27607 | 2006-06-06 |
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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.