PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1174823066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174823066 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | TRIANGLE HEART ASSOCIATES |
| Practice Address |
1821 Hillandale Rd Ste. 25c Durham NC 27705-2659 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9192205510 |
| Mailing Telephone | 9196204918 |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2013-02-12 |
| Authorized Official Name | PAUL R NEWMAN (EXECUTIVE DIRECTOR, PDC) |
| Authorized Official Telephone | 9196137652 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Triangle Heart Associates | 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 |
1821 HILLANDALE RD STE. 25C |
| City | DURHAM |
| State | NC |
| Zip Code | 27705-2659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295795201 | John Stewart Jones | Internal Medicine | 1821 Hillandale Rd, Suite 25c, Durham, NC 27705-2659 | 2006-03-24 |
| 1376904664 | Greta Germino | Dietitian, Registered | 1821 Hillandale Rd, Durham, NC 27705-2659 | 2016-03-14 |
| 1316307572 | Rebecca May | Physician Assistant | 1821 Hillandale Rd, Durham, NC 27705-2659 | 2016-03-02 |
| 1104282540 | Christopher Clark | Physician Assistant | 1821 Hillandale Rd, Ste 24a, Durham, NC 27705-2659 | 2016-01-14 |
| 1871967919 | Katherine Elizabeth Prince | Registered Nurse | 1821 Hillandale Rd, Ste 25a, Durham, NC 27705-2659 | 2015-11-29 |
| 1447622295 | Elise Patricia Michnowicz | Nurse Practitioner | 1821 Hillandale Rd, Suite 24b, Durham, NC 27705-2659 | 2015-10-20 |
| 1033532320 | Deborah Nowack | Registered Nurse | 1821 Hillandale Rd, Suite 24b, Durham, NC 27705-2659 | 2014-01-23 |
| 1669713590 | Private Diagnostic Clinic, Pllc | Allergy & Immunology | 1821 Hillandale Rd, Ste. 25a, Durham, NC 27705-2659 | 2013-03-01 |
| 1295019784 | James Franklin Killian | Pharmacist | 1821 Hillandale Rd, Durham, NC 27705-2659 | 2011-10-03 |
| 1508090275 | Zachary Ryan Healy | Internal Medicine | 1821 Hillandale Rd, Duke Asthma, Allergy, Airway Center, Durham, NC 27705-2659 | 2009-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371755 | Tyler Beach, Lcsw, Pllc | Social Worker | 2740 Spencer Street, Durham, NC 27705 | 2019-11-20 |
| 1720635477 | Brittany W Fry | Registered Nurse | 2301 Erwin Road, Hafs Building, Room 6670, Durham, NC 27705 | 2019-08-19 |
| 1760968044 | Nicole D Moore | Social Worker | 1921 N. Pointe Dr, Suite 280, Durham, NC 27705 | 2018-07-19 |
| 1144757097 | Emileigh S Dowling | Physical Therapist | 3475 Erwin Rd Bldg 2, Durham, NC 27705 | 2017-05-22 |
| 1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
| 1780131839 | Michael A Fitzpatrick Iv | Physical Therapist | 3475 Erwin Rd Bldg 2nd, Durham, NC 27705 | 2016-09-07 |
| 1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
| 1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
| 1720486988 | Jennifer Dawn Pace | Physician Assistant | 1821 Hillandale Road Suite 24a, Duke Urgent Care, Durham, NC 27705 | 2014-12-19 |
| 1942612106 | Rachel Hibberd | Psychologist | 508 Fulton Avenue, Durham Va Medical Center, Durham, NC 27705 | 2014-05-22 |
| Find all providers in zip 27705 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619467529 | Clerio Francisco De Azevedo Filho | Internal Medicine | 10 Medicine Circle - Duke Medical Pavilion Room 1e50, Durham, NC 27710-0001 | 2018-05-16 |
| 1376956714 | Anthony Carnicelli | Internal Medicine | 2301 Erwin Rd Dumc 3845 Duke University Hospital, Durham, NC 27710-6110 | 2014-06-03 |
| 1508289398 | Shabina Sheikh | Internal Medicine | 6 Dawson Ct, Durham, NC 27703-9424 | 2014-01-29 |
| 1013262419 | Marat Fudim | Internal Medicine | 7624a Hosp N, Cardiology Program Office, Durham, NC 27710 | 2012-07-23 |
| 1134417660 | Amit Vipin Patel | Internal Medicine | 1821 Hillandale Rd Ste 25c, Durham, NC 27705-2671 | 2011-07-18 |
| 1861636300 | Tiffany Patrice Randolph | Internal Medicine | Dumc Box 3182, Duke University Internal Medicine Program, Durham, NC 27710 | 2009-04-28 |
| 1588831903 | Zainab Samad | Internal Medicine | Orange Zone Duke Rm 3347a, 200 Trent Drive, Durham, NC 27710-0001 | 2008-05-14 |
| 1275709149 | Deepak Voora | Internal Medicine | 905 S Lasalle St, 2004 - Snyderman Building, Durham, NC 27710-3017 | 2008-05-01 |
| 1386817104 | Jason Koontz | Internal Medicine | 3919 Sterling Ridge Ln, Durham, NC 27707-5459 | 2008-04-13 |
| 1932381829 | Richa Agarwal | Internal Medicine | Duke University Medical Center 2301 Erwin Road, Durham, NC 27710 | 2007-12-03 |
| Find all providers in DURHAM | ||||
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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.