PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1447480413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447480413 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | DUKE ORTHOPEDICS OF VANCE COUNTY |
| Practice Address |
511 Ruin Road Suite 106 Henderson NC 27536-5919 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9196848111 |
| Mailing Telephone | 9196848111 |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2011-12-08 |
| Authorized Official Name | MR. MARK L CANTRRELL (CHIEF PRIVACY & COMPLIANCE OFFICER) |
| Authorized Official Telephone | 9196685161 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Duke Orthopedics of Vance County | 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 |
| 1841446762 | Private Diagnostic Clinic, Pllc | Otolaryngology | 783 Doctors Ct Ste C, Roxboro, NC 27573-4575 | 2008-08-12 |
| 1770600363 | Private Diagnostic Clinic, Pllc | Internal Medicine | 95 Springbrook Ave, Suite 111, Clayton, NC 27520-8520 | 2007-03-26 |
| 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 |
511 RUIN ROAD SUITE 106 |
| City | HENDERSON |
| State | NC |
| Zip Code | 27536-5919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952940926 | Lane and Associates Xxxvi Dds Pa | Dentist | 900 South Garnett St., Henderson, NC 27536 | 2019-12-23 |
| 1487012076 | Melissa Burroughs | Registered Nurse | 943-h W. Andrews Avenue, Henderson, NC 27536 | 2016-02-10 |
| 1578949269 | Growth Recovery Opportunity & Wellness | Community/Behavioral Health | 804 South Garnett St, Henderson, NC 27536 | 2015-08-04 |
| 1003290297 | Saintpaulhealthcarept, Inc. | Home Health | 839 E Montgomery St, Henderson, NC 27536 | 2015-07-17 |
| 1518369859 | Kristina Thornton | Pharmacist | 200 North Cooper Road, Henderson, NC 27536 | 2014-09-18 |
| 1306285135 | Green Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 429 Sunnyview Road, Henderson, NC 27536 | 2013-06-14 |
| 1760820278 | Innovative Health Services | In Home Supportive Care | 1758 Parham Street, Henderson, NC 27536 | 2013-06-06 |
| 1578900015 | Frances Veronica Finamore | Counselor | 710 Parham Street, Henderson, NC 27536 | 2013-05-23 |
| 1952530834 | Sucessful Achievements Program Incorporated | Driver | 133 Us 1 A, Norlina, NC 27536 | 2009-07-13 |
| 1407096100 | Recovery Response Center | Psychiatric Hospital | 300 Parkview Drive, Henderson, NC 27536 | 2009-02-20 |
| Find all providers in zip 27536 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437531902 | Laura M. Bruse, M.d., P.C. | Orthopaedic Surgery | 1452 W. Horizon Ridge Pkwy #510, Henderson, NV 89012 | 2015-06-22 |
| 1396087623 | Carl Bradley Wallis | Orthopaedic Surgery | 10561 Jeffreys St Ste 230, Henderson, NV 89052-4268 | 2013-03-25 |
| 1124339676 | Mark Allen | Orthopaedic Surgery | 1505 Wigwam Pkwy Ste 330, Henderson, NV 89074 | 2010-06-30 |
| 1588793533 | Caleb Ogden Pinegar | Orthopaedic Surgery | 2779 W Horizon Ridge Pkwy Ste 200, Henderson, NV 89052-4186 | 2007-03-05 |
| 1033269147 | Michael J Crovetti Jr. | Orthopaedic Surgery | 2779 W. Horizon Ridge Pkwy., Ste. 200, Henderson, NV 89052-4380 | 2007-01-11 |
| 1942243324 | Ronald Curtis Koe | Orthopaedic Surgery | 1710 W. Horizon Ridge Pkwy, Ste 120, Henderson, NV 89012 | 2006-06-14 |
| 1376500181 | Frederick Charles Balduini | Orthopaedic Surgery | 2779 W Horizon Ridge, Ste 200, Henderson, NV 89052-4380 | 2006-04-26 |
| 1104893031 | Frederick Charles Redfern | Orthopaedic Surgery | 1701 N Green Valley Pkwy Ste 4b, Henderson, NV 89074-5886 | 2006-02-28 |
| 1750371233 | John E Herr | Orthopaedic Surgery | 1701 N Green Valley Pkwy Ste 4c, Henderson, NV 89074-5886 | 2005-10-25 |
| 1922007244 | Patrick S. Mcnulty | Orthopaedic Surgery | 3175 Saint Rose Pkwy Ste 320, Henderson, NV 89052-3508 | 2005-07-19 |
| Find all providers in HENDERSON | ||||
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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.