PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1306078803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306078803 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | DUKE DIET AND FITNESS (PDC) |
| Practice Address |
501 Douglas St Durham NC 27705-3888 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9196848111 |
| Mailing Telephone | 9196848111 |
| Enumeration Date | 2009-08-17 |
| 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 | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Duke Diet and Fitness (PDC) | 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 |
501 DOUGLAS ST |
| City | DURHAM |
| State | NC |
| Zip Code | 27705-3888 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346405131 | Lisa Marker | Dietitian, Registered | 501 Douglas St, Durham, NC 27705-3888 | 2008-07-22 |
| 1477080190 | Morven Ann Ross Malay | Physical Therapist | 501 Douglas St, Durham, NC 27705-3888 | 2017-05-11 |
| 1881077881 | Christine Marie Baright | Physical Therapist | 501 Douglas St, Durham, NC 27705-3888 | 2015-07-08 |
| 1952650624 | Keri Linares | Dietitian, Registered | 501 Douglas St, Durham, NC 27705-3888 | 2012-09-10 |
| 1336448810 | Duke University Health System, Inc. | Psychologist | 501 Douglas St, Durham, NC 27705-3888 | 2011-03-23 |
| 1629216460 | Sofia Helen Rydin-gray | Psychologist | 501 Douglas St, Durham, NC 27705-3888 | 2009-02-02 |
| 1619115078 | Duke Diet and Fitness Center | Residential Treatment Facility, Physical Disabilities | 501 Douglas St, Durham, NC 27705-3888 | 2009-01-23 |
| 1639334998 | Elisabetta Politi | Nutritionist | 501 Douglas St, Durham, NC 27705-3888 | 2008-07-25 |
| 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 | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093928376 | Jennifer Rowell | Internal Medicine | Duke University Medical Center Clinic 1a, 30 Duke Medicine Circle, Durham, NC 27710-0001 | 2007-05-07 |
| 1639205800 | Teresa Napier | Internal Medicine | Dumc 3510, Durham, NC 27710-0001 | 2007-02-24 |
| 1669516282 | Jean C. Litton | Internal Medicine | Dumc 3080, Durham, NC 27710-0001 | 2007-02-16 |
| 1811036585 | Francis Albert Neelon | Internal Medicine | 2609 N Duke St Bldg 800, Durham, NC 27704-3048 | 2007-02-06 |
| 1770674517 | Jennifer Brigitte Green | Internal Medicine | Duke University Medical Center/ Div of Endocrinology, Dumc Box 3222, Baker House Room 280, Durham, NC 27710-0001 | 2006-09-27 |
| 1700853777 | Karen Barnard | Internal Medicine | Baker House 227, Dumc, Durham, NC 27710-0001 | 2006-03-08 |
| 1700853660 | Tracy M Black | Internal Medicine | 4220 N Roxboro St, Durham, NC 27704-1826 | 2006-03-01 |
| 1376515635 | Nicole Elise Jelesoff | Internal Medicine | Dumc 3973, Duke University Medical Center, Durham, NC 27710-0001 | 2006-02-02 |
| 1174830426 | Samy Hadjadj | Internal Medicine | 106 Research Dr, Msrb II Room 2045, Durham, NC 27710-0004 | 2010-09-08 |
| 1609019090 | Lauren Fritz Gratian | Internal Medicine | 30 Duke Medicine Cir, Durham, NC 27710-3000 | 2009-04-14 |
| 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.