PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1255658472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255658472 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | DUKE DERMATOLOGY-PATTERSON PLACE |
| Practice Address |
5324 Mcfarland Rd Ste. 210 Durham NC 27707-6865 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9196848111 |
| Mailing Telephone | 9196848111 |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2011-12-09 |
| Authorized Official Name | MR. MARK L CANTRELL (CHIEF PRIVACY & COMPLIANCE OFFICER) |
| Authorized Official Telephone | 91966685161 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Duke Dermatology-Patterson Place | 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 |
5324 MCFARLAND RD STE. 210 |
| City | DURHAM |
| State | NC |
| Zip Code | 27707-6865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174562102 | Diana Borton Mcshane | Dermatology | 5324 Mcfarland Rd, Suite 410, Durham, NC 27707-6865 | 2006-06-05 |
| 1316392764 | Amanda Birkhead | Dietitian, Registered | 5324 Mcfarland Rd, Ste 150, Durham, NC 27707-6865 | 2016-05-03 |
| 1679927255 | Gregory Schiltz | Dietitian, Registered | 5324 Mcfarland Rd, Durham, NC 27707-6865 | 2016-04-20 |
| 1871973396 | Durham Lifestyle Management LLC | Dietitian, Registered | 5324 Mcfarland Rd, Ste 150, Durham, NC 27707-6865 | 2015-06-01 |
| 1942695200 | Ashton Jackson | Dietitian, Registered | 5324 Mcfarland Rd, Suite 150, Durham, NC 27707-6865 | 2015-04-03 |
| 1811385875 | Sarah Ray Healy | Dietitian, Registered | 5324 Mcfarland Rd, #150, Durham, NC 27707-6865 | 2014-12-29 |
| 1568887487 | Jessica R Iselin | Dietitian, Registered | 5324 Mcfarland Rd, Suite 150, Durham, NC 27707-6865 | 2014-02-28 |
| 1134540768 | Deborah Franciscy | Dietitian, Registered | 5324 Mcfarland Rd, Suite 150, Durham, NC 27707-6865 | 2013-12-27 |
| 1831520188 | Tyrone Hall | Dietitian, Registered | 5324 Mcfarland Rd, Suite 150, Durham, NC 27707-6865 | 2013-12-11 |
| 1548691975 | Ashley Karshen | Dietitian, Registered | 5324 Mcfarland Rd, Durham, NC 27707-6865 | 2013-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538785928 | Ceara Smith | Social Worker | 1415 W Nc 54 Buidling 200, Suite 111, Durham, NC 27707 | 2020-06-22 |
| 1114554094 | Lauren Michelle Grosse | Physician Assistant | Fastmed Urgent Care 7010 Nc-751, Durham, NC 27707 | 2020-03-23 |
| 1386289635 | Ashley Bailey | Counselor | 1801 Fayetteville Street, Durham, NC 27707 | 2019-11-11 |
| 1881249886 | Erin Ramona Leger | Physical Therapist | 3706 Mayfair St, Ste 120, Durham, NC 27707 | 2019-08-06 |
| 1417417262 | Carmen Elisabeth Sanchez | Psychologist | 3326 Durham Chapel Hill Blvd Bldg D, Durham, NC 27707 | 2019-03-20 |
| 1477026144 | Pope Behavioral Health and Wellness | Counselor | 5102 Chapel Hill Durham Blvd., Suite 101, Durham, NC 27707 | 2019-01-06 |
| 1043780778 | Jessica Ann Revels | Counselor | 1415 West North Carolina 54, Building 100 Suite # 204, Durham, NC 27707 | 2018-11-26 |
| 1558830125 | Michael Brown | Counselor | 1502 W Nc-54, Suite 505, Durham, NC 27707 | 2018-11-13 |
| 1780152827 | Cassandra Gerwig Shaw | Registered Nurse | 5324 Mcfarland Dr Ste 310, Durham, NC 27707 | 2018-11-07 |
| 1942776232 | Lisa J Keskitalo | Physical Therapist | 3708 Mayfair St Ste 120, Durham, NC 27707 | 2018-10-15 |
| Find all providers in zip 27707 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073172433 | Elaine Otchere | Dermatology | M145 Green Zone Duke South 40 Duke Medicine Circle, Durham, NC 27710-8267 | 2019-06-10 |
| 1467832881 | Skin Wellness Dermatology Associates, Pa | Dermatology | 245 East Nc Highway 54, Ste 202, Durham, NC 27713-2150 | 2015-06-01 |
| 1588077499 | Amber Ingram Fresco | Dermatology | 40 Duke Medicine Circle, Clinic 3k, Durham, NC 27710 | 2014-06-09 |
| 1407021165 | Adela Rambi Guanco Cardones | Dermatology | Dumc 3822, Durham, NC 27710 | 2008-04-24 |
| 1952592149 | Sarah Ann Wolfe | Dermatology | Duke Univ Med Center Dermatology Dept, Room 3385, Orange Zone, Duke South, Box 3643, Durham, NC 27710-0001 | 2007-08-05 |
| 1093887960 | Brooke A Jackson | Dermatology | 245 E Nc Highway 54, Suite 202, Durham, NC 27713-2551 | 2006-11-15 |
| 1023195930 | John F Carr | Dermatology | 4012 Colville Rd, Durham, NC 27707-5084 | 2006-11-01 |
| 1205923042 | Russell Pritchett Hall IIi | Dermatology | 200 Trent Drive, Duke University Medical Center, Durham, NC 27715-3135 | 2006-10-05 |
| 1306947148 | Navjeet Kaur Sidhu-malik | Dermatology | 3385 Trent Dr, Dumc 3643, Durham, NC 27710-0001 | 2006-09-26 |
| 1942237094 | Garrett Schell Bressler | Dermatology | 1920 Front St, Durham, NC 27705 | 2006-06-26 |
| 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.