PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1326361189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326361189 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | DUKE CHILDREN'S CARDIOLOGY OF LUMBERTON |
| Practice Address |
400 Liberty Hill Rd Lumberton NC 28358-3014 |
| Mailing Address |
Po Box 900002 Raleigh NC 27675-9000 |
| Practice Telephone | 9107393318 |
| Practice Fax Number | 9106713600 |
| Mailing Telephone | 9196204700 |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2010-05-26 |
| Authorized Official Name | JOHN P. DION (CFO-PDC) |
| Authorized Official Telephone | 9196137762 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Duke Children's Cardiology of Lumberton | 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 |
400 LIBERTY HILL RD |
| City | LUMBERTON |
| State | NC |
| Zip Code | 28358-3014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528064599 | William Scott Ryan | Pediatrics | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2005-06-24 |
| 1699305060 | Jacklynn Lindsey Hunt | Physician Assistant | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2020-01-24 |
| 1376181487 | Jessica Nicole Fairfax | Nurse Practitioner | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2019-12-19 |
| 1174031173 | Danielle Nicole Chavis | Physician Assistant | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2018-01-12 |
| 1417467408 | Kandis Danielle Atkins | Family Medicine | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2017-10-04 |
| 1881126738 | Michelle Lin | Pediatrics | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2017-03-30 |
| 1255764536 | Candace Michelle Lowry | Nurse Practitioner | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2013-08-09 |
| 1124371646 | Coastal Childrens Services Pllc | Pediatrics | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2012-10-22 |
| 1689924268 | Christie Lynne Hagan | Physician Assistant | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2012-09-11 |
| 1063760031 | Children's Health of Carolina, Pa | Pediatrics | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2012-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649812397 | Monarch | Community/Behavioral Health | 13128 Serenity Street, Huntersville, NC 28358 | 2019-10-15 |
| 1114577194 | Lashonda Patrice Bostic | Social Worker | 4719 Fayetteville Road, Lumberton, NC 28358 | 2019-09-12 |
| 1780232389 | Rosaline Whittington | Technician | 39 Sibley Road, Lumberton, NC 28358 | 2019-08-28 |
| 1790343168 | Emily Graham | Social Worker | 401 S. 27th Street, Lumberton, NC 28358 | 2019-05-31 |
| 1316420722 | Karen Lynn Warwick | Nurse Practitioner | 600 Farringdom St # Ab, Lumberton, NC 28358 | 2018-09-11 |
| 1982184149 | Virginia Feldick Hampton | Speech-Language Pathologist | Coastal Therapy Partners, 210 Liberty Hill Road, Lumberton, NC 28358 | 2018-08-17 |
| 1366941882 | Ashlynn Faircloth Mckeithan | Occupational Therapist | 210 Liberty Hill Road, Lumberton, NC 28358 | 2018-02-10 |
| 1992153506 | Matthew Mercer | Nurse Anesthetist, Certified Registered | 2703 Riverwood Ave, Lumberton, NC 28358 | 2016-05-25 |
| 1295100964 | Chosen Health Care Services Inc | In Home Supportive Care | 705b Wesley Pines Road, Lumberton, NC 28358 | 2015-12-07 |
| 1346626173 | Brittany Renea Chavis | Social Worker | 888 Wire Grass Road, Lumberton, NC 28358 | 2015-08-04 |
| Find all providers in zip 28358 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912354374 | Carolina Children's Heart Specialists | Pediatrics | 1018 W H Smith Boulevard, Greenville, NC 27834 | 2016-05-16 |
| 1215317060 | Forsyth Memorial Hospital, Inc | Pediatrics | 1941 New Garden Road, Suite 216, Greensboro, NC 27410 | 2015-06-08 |
| 1487903423 | Private Diagnostic Clinic, Pllc | Pediatrics | 540 New Waverly Place, Ste.101, Cary, NC 27518-7422 | 2012-09-06 |
| 1548525470 | Bailliard Henry Pediatric Cardiology | Pediatrics | 4301 Lake Boone Trail, Suite 300, Raleigh, NC 27607 | 2012-07-06 |
| 1275858698 | Carolinas Physicians Network, Inc. | Pediatrics | 705 Griffith Street, Suite 100, Davidson, NC 28036-9305 | 2010-03-29 |
| 1073838496 | Carolinas Physicians Network, Inc. | Pediatrics | 6030 West Highway 74, Suite F, Indian Trail, NC 28079-3469 | 2010-03-29 |
| 1952626376 | Carolinas Physicians Network, Inc. | Pediatrics | 14214 Ballantyne Lake Road, Suite 150, Charlotte, NC 28277-3373 | 2010-03-29 |
| 1902121320 | Carolinas Physicians Network Inc | Pediatrics | 16623 Birkdale Cmns Pkwy Ste 110, Huntersville, NC 28078-5622 | 2010-03-29 |
| 1801023494 | Patsy W Park | Pediatrics | 1545 Orchard Villas Ave Ste 110, Apex, NC 27502-4339 | 2009-06-22 |
| 1114152469 | Frances Chen Travelli | Pediatrics | 1718 E 4th St Ste 605, Charlotte, NC 28204-3282 | 2009-05-15 |
| Find all providers with the same taxonomy | ||||
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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.