PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1972826568) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972826568 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | SOUTHERN HIGH WELLNESS CTR. |
| Practice Address |
800 Clayton Rd Durham NC 27703-2606 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9195602536 |
| Mailing Telephone | 9196848111 |
| Enumeration Date | 2010-03-10 |
| Last Update Date | 2012-04-25 |
| Authorized Official Name | MRS. CECELIA B MOORE (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9196137762 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Southern High Wellness Ctr. | 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 |
| 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 |
800 CLAYTON RD |
| City | DURHAM |
| State | NC |
| Zip Code | 27703-2606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023641271 | Lydia A Kiefer | Counselor | 800 Clayton Rd, Durham, NC 27703-2606 | 2020-02-17 |
| 1972800126 | Nicole Victoria Ferguson | Dietitian, Registered | 800 Clayton Rd, Durham, NC 27703-2606 | 2011-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285235218 | Joseph Omalemigbo Abgateyiniro | Durable Medical Equipment & Medical Supplies | 1810 Shiva Court, Durham, NC 27703 | 2020-11-05 |
| 1326654278 | Step By Step In Home Care LLC | Home Health | Imperial Business Park, 4819 Emperor Blvd Suite 400, Durham, NC 27703 | 2020-09-16 |
| 1023598463 | Impact Therapy Services | Speech-Language Pathologist | 6 Winnabow Court, Durham, NC 27703 | 2018-08-15 |
| 1326536327 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 1100 N Miami Blvd Ste 500a, Durham, NC 27703 | 2018-04-25 |
| 1033621719 | Duke University | Preventive Medicine | 4825 Creekstone Drive, Suite 105, Durham, NC 27703 | 2017-11-02 |
| 1023535564 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3725 Wake Forest Hwy, Durham, NC 27703 | 2017-08-25 |
| 1487194171 | Shivani L. Chudasama | Social Worker | 5475 Lumley Rd Ste 103, Durham, NC 27703 | 2017-03-01 |
| 1356886030 | Rgh Enterprises, Inc. | Durable Medical Equipment & Medical Supplies | 4234 Surles Court, Suite 100, Durham, NC 27703 | 2017-01-04 |
| 1780032821 | Victory Speech Therapy Services, Pllc | Speech-Language Pathologist | 1533 Ellis Rd., Apt J208, Durham, NC 27703 | 2016-05-31 |
| 1124422373 | Helene Azimbi Fonebi | Pharmacist | 8 Gandhi Dr, Durham, NC 27703 | 2014-10-17 |
| Find all providers in zip 27703 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750923215 | Carolina Health Clinic | Family Medicine | 2634 Durham Chapel Hill Blvd Ste 216, Durham, NC 27707-2800 | 2019-10-16 |
| 1235789215 | Rachel Cahoon Gray | Family Medicine | 3601 Grouse Ct, Durham, NC 27704-2488 | 2019-09-12 |
| 1285108209 | Tywana Donaldson | Family Medicine | 30 Medicine Circle, Durham, NC 27710-3038 | 2019-01-12 |
| 1396247839 | Better Life Family Center | Family Medicine | 308 S Woodcrest St Apt 5, Durham, NC 27703-3374 | 2018-02-28 |
| 1306378005 | Southpoint Family Medicine, Pllc | Family Medicine | 1515 W Nc Highway 54 Ste 130, Durham, NC 27707-5575 | 2017-03-31 |
| 1174068803 | Theodore Bruno | Family Medicine | 12 Pleasant Ter, Durham, CT 06422-2305 | 2017-01-04 |
| 1588018550 | Asiyah Zahra Mikell | Family Medicine | 516 Tall Oaks Dr, Durham, NC 27713-9358 | 2016-04-15 |
| 1114380797 | Alexa Maureen Mieses Malchuk | Family Medicine | 3708 Mayfair St., Suite 100, Durham, NC 27707 | 2016-04-01 |
| 1730593898 | Senait Fremichael Efrem | Family Medicine | 1821 Hillandale Rd Ste 24b, Durham, NC 27705-2671 | 2014-06-17 |
| 1699187963 | James Barlow | Family Medicine | 7 Mill Road Plz # C, Durham, NH 03824-3047 | 2014-05-21 |
| 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.