PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1609116664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609116664 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | VIRGINIA LIGHTNER FAMILY DERMATOLOGY |
| Practice Address |
82 Wheaton Ave Youngsville NC 27596-8691 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9195628887 |
| Mailing Telephone | 9196848111 |
| Enumeration Date | 2013-02-27 |
| Last Update Date | 2013-06-14 |
| 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 | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Virginia Lightner Family Dermatology | 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 |
| 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 |
| 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 |
82 WHEATON AVE |
| City | YOUNGSVILLE |
| State | NC |
| Zip Code | 27596-8691 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144879313 | Harp Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 12339 Wake Union Church Rd Ste 108, Wake Forest, NC 27596 | 2019-09-10 |
| 1326560806 | Nirali Patel | Pharmacist | 1190 Us Hwy 1n, Youngsville, NC 27596 | 2017-07-17 |
| 1790109577 | Riphen Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 203 Blue Heron Drive, Youngsville, NC 27596 | 2014-02-13 |
| 1831524768 | Janice D Clark, Dds, Pa | Dentist | 680 Us Hwy 1 N, Suite 500, Youngsville, NC 27596 | 2013-09-11 |
| 1720372733 | Sherri Culbertson | Pharmacist | 1190 Us Hwy 1 North, Youngsville, NC 27596 | 2011-06-07 |
| 1326368390 | Trg Health Care Systems LLC | Social Worker | 112 Wheaton Ave, Suite B, Youngsville, NC 27596 | 2010-06-01 |
| 1932250065 | Catherine Grace Busam | Counselor | 90 Wheaton Dr, Youngsville, NC 27596 | 2007-01-16 |
| 1316022700 | Emmett Smoak Ackermon Jr. | Dentist | 66 Wheaton Ave, Youngsville, NC 27596 | 2006-10-26 |
| 1750323960 | Matthew Mullen | Specialist | 700 Us 1 Hwy Ste 100, Youngsville, NC 27596 | 2006-06-12 |
| 1992074314 | Trg Health Care Systems LLC | Community/Behavioral Health | 112 Wheaton Ave, Suite B, Youngsville, NC 27596 | 2011-12-14 |
| Find all providers in zip 27596 | ||||
| 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 |
|---|---|---|---|---|
| 1770557878 | Virginia A. Lightner | Dermatology | 82 Wheaton Dr, Youngsville, NC 27596-8691 | 2006-02-15 |
| 1780773416 | Virginia Lightner Family Dermatology, Pa | Dermatology | 82 Wheaton Dr, Youngsville, NC 27596-8691 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811128 | Foothills Family Dermatology | Dermatology | 118 North Sterling St, Morganton, NC 28655 | 2020-11-04 |
| 1316556871 | Easterm Dermatology, Pa | Dermatology | 1840 Nc Hwy 24, Newport, NC 28570 | 2020-07-30 |
| 1548878549 | Clara Dermatology | Dermatology | 7250 O'kelly Chapel Road, Suite 100, Cary, NC 27519 | 2020-07-16 |
| 1841837507 | Southeast Vulvar Clinic, Pllc | Dermatology | 6406 Carmel Road, Suite 309, Charlotte, NC 28226 | 2019-12-02 |
| 1205481009 | Novant Medical Group Inc | Dermatology | 6324 Fairview Rd # 200, Charlotte, NC 28210-3271 | 2019-08-08 |
| 1073172433 | Elaine Otchere | Dermatology | M145 Green Zone Duke South 40 Duke Medicine Circle, Durham, NC 27710-8267 | 2019-06-10 |
| 1902469570 | Falling Leaves Dermatology Mooresville LLC | Dermatology | 136 Corporate Park Dr Ste H, Mooresville, NC 28117-6960 | 2019-04-18 |
| 1669945259 | Claire Engel Holmquist | Dermatology | 11301 Golf Links Dr N Ste 203, Charlotte, NC 28277-8014 | 2019-01-07 |
| 1497227144 | Integrated Dermatology of North Carolina, Pllc | Dermatology | 10512 Park Rd Ste 113, Charlotte, NC 28210-8469 | 2018-12-19 |
| 1558848093 | Dermatology Consultants of Asheville Pllc | Dermatology | 218 Elkwood Ave # 104, Woodfin, NC 28804-2247 | 2018-07-27 |
| Find all providers with the same taxonomy | ||||
| City | YOUNGSVILLE |
| Zip Code | 27596 |
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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.