PRIVATE DIAGNOSTIC CLINIC, PLLC


Address: 3404 Wake Forest Rd, Suite 100, Raleigh, NC 27609-7340
Phone: 9199543050

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RH0003X Internal Medicine
Specialization: Hematology & Oncology
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NC BCBS GRP 011GH 01
NC 89011GH 05

Other Provider/Organization Names

Other Name Type Code
Duke Hematology /Oncology @Duke Health Raleigh Hospital 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
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

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 3404 WAKE FOREST RD
SUITE 100
City RALEIGH
State NC
Zip Code 27609-7340

Providers in the same location

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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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207RH0003X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Hematology & Oncology

Taxonomy Definition

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

Providers in the same taxonomy and city

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
Find all providers in RALEIGH

Competitor

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City RALEIGH
Zip Code 27609

Improve Information

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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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