PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1962428466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962428466 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | DURHAM OB/GYN |
| Practice Address |
2609 N Duke St Suite 204 Durham NC 27704-3048 |
| Mailing Address |
Po Box 900002 Raleigh NC 27675-9000 |
| Practice Telephone | 9196848111 |
| Mailing Telephone | 9196848111 |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2009-05-14 |
| Authorized Official Name | JOHN PAUL DION (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9196137762 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5950788 | 05 | |
| NC | BCBS GRP | 07020 | 01 |
| Other Name | Type Code |
|---|---|
| Durham OB/GYN | 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 |
2609 N DUKE ST SUITE 204 |
| City | DURHAM |
| State | NC |
| Zip Code | 27704-3048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124019849 | Kiron Clinical Sleep Lab, LLC | Specialist | 2609 N Duke St, Suite 604, Durham, NC 27704-3048 | 2005-11-02 |
| 1184232852 | Virgina Ward | Nurse Practitioner | 2609 N Duke St, Durham, NC 27704-3048 | 2020-07-20 |
| 1679950877 | Stacey Phillips | Social Worker | 2609 N Duke St, Suite 504, Durham, NC 27704-3048 | 2015-04-27 |
| 1982094637 | Kelsey Daly | Nurse Practitioner | 2609 N Duke St, Suite 204, Durham, NC 27704-3048 | 2015-02-03 |
| 1174950281 | Eileen Gail Williams | Counselor | 2609 N Duke St, Suite 303b, Durham, NC 27704-3048 | 2013-10-03 |
| 1659627271 | Family Preservation Services | Community/Behavioral Health | 2609 N Duke St, Suite 504, Durham, NC 27704-3048 | 2012-08-01 |
| 1578820635 | Audrina Jones Bunton | Counselor | 2609 N Duke St, Suite 504, Durham, NC 27704-3048 | 2012-04-13 |
| 1063784304 | Champion & Champion Pa Inc | Psychologist | 2609 N Duke St, 602, Durham, NC 27704-3048 | 2012-02-02 |
| 1942578554 | Premiere Health and Wellness Medical Center | Pediatrics | 2609 N Duke St, Suite 403, Durham, NC 27704-3048 | 2011-12-09 |
| 1952635161 | Jennifer Stasko | Physical Therapist | 2609 N Duke St, Suite 203, Durham, NC 27704-3048 | 2009-09-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723139 | Devang Ashokbhai Patel | Dentist | 2609 N Duke St Ste 618, Durham, NC 27704 | 2018-06-14 |
| 1891201042 | Little Family Care Home, LLC | Custodial Care Facility | 1012 Davinci Street, Durham, NC 27704 | 2017-12-26 |
| 1033625702 | Tondra A Little | Social Worker | 2804 Nellowood Street, Durham, NC 27704 | 2017-12-18 |
| 1437502408 | Jhazmere Shamas Preston | Counselor | 2609 N. Duke St. Suite 403, Durham, NC 27704 | 2016-07-14 |
| 1649626656 | Professional Elevations Pllc | Case Manager/Care Coordinator | 304 Crutchfield Drive, Durham, NC 27704 | 2016-05-09 |
| 1083071617 | Alyssa Wilson | Speech-Language Pathologist | 215 William Penn Plz Apt 908, Durham, NC 27704 | 2016-01-27 |
| 1932565124 | Arthur Reynolds Jr and Associates P.l.l.c. | Dentist | 2106 N Duke St, Durham, NC 27704 | 2016-01-05 |
| 1962877720 | Chimere Brooks | Contractor | 4001meriwether Drive Apt P-19, Durham, NC 27704 | 2015-12-04 |
| 1184013294 | Danielle King | Physician Assistant | 3611 N Duke Street, Durham, NC 27704 | 2015-01-13 |
| 1730581901 | Images, 'of Me To You' | Community/Behavioral Health | 2823 Cascadilla Street, Durham, NC 27704 | 2014-09-19 |
| Find all providers in zip 27704 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| 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 Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194144063 | Jordan Enns Schaumberg | Obstetrics & Gynecology | 5324 Mcfarland Rd Ste 300, Durham, NC 27707-6864 | 2014-04-08 |
| 1710253349 | Latoya Patterson | Obstetrics & Gynecology | 1602 Harrier Ct, Durham, NC 27713-9100 | 2012-03-28 |
| 1396986279 | John Harrison Baker | Obstetrics & Gynecology | 400 Crutchfield Street, Ste. B, Durham, NC 27704 | 2009-03-23 |
| 1730344417 | Dmitry Fridman | Obstetrics & Gynecology | 40 Duke Medicine Cir Dept Of, Durham, NC 27710-4000 | 2008-07-22 |
| 1417136508 | Lynda B Mchutchison | Obstetrics & Gynecology | 5309 Highgate Dr, Durham, NC 27713-8501 | 2007-10-25 |
| 1912199126 | Beverly Allen Gray | Obstetrics & Gynecology | 203 Baker House, Durham, NC 27710-0001 | 2007-08-11 |
| 1043418163 | Ryan Timothy Bakelaar | Obstetrics & Gynecology | 122 Eagles Nest Dr, Durham, NC 27712-2989 | 2007-07-10 |
| 1760692313 | Amy Nicole Broach | Obstetrics & Gynecology | Po Box Office, Box 3609, Durham, NC 27710-0001 | 2007-05-23 |
| 1720115827 | Jennifer E Norten | Obstetrics & Gynecology | Dumc 3119, Durham, NC 27710-0001 | 2007-02-27 |
| 1558425272 | Shelley Rice | Obstetrics & Gynecology | 40 Medicine Circle Blue Zone Room 3688, Durham, NC 27710-0001 | 2006-12-20 |
| 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.