Private Diagnostic Clinic, PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

PRIVATE DIAGNOSTIC CLINIC, PLLC

Doing business as

Psychiatry Erwin Square

Practice address

2200 W Main St
Ste 340
Durham, NC 27705-4640

Phone

(919) 416-3439

NPI assigned

Oct 12, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christopher T Frederick

Title

Cfo

Phone

(919) 620-4918

Specialties & licenses 1

Addresses

Other names 1

• Psychiatry Erwin Square Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Carolyn Plumb Vilardaga, PH.D.

  • Clinical Psychologist
  • Durham, NC
  • NPI 1912346339
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652400000000",
    "number": "1093265241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110566",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277095566",
            "telephone_number": "919-620-4855",
            "fax_number": "919-620-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W MAIN ST",
            "address_2": "STE 340",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054640",
            "telephone_number": "919-416-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE DIAGNOSTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A",
        "authorized_official_last_name": "FREDERICK",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "919-620-4918"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychiatry Erwin Square",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Psychiatry Erwin Square",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erica B Pritzker, PSYD
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• Private Diagnostic Clinic, PLLC (Durham OB/GYN)
• Private Diagnostic Clinic, PLLC (DukePDCPTOT)
• Private Diagnostic Clinic, PLLC (Duke Sports Medicine Center Clinic)
• Private Diagnostic Clinic, PLLC (Regional Neurosurgery)
• Private Diagnostic Clinic, PLLC (Triangle Heart Associates)

• Psychologist in Durham, NC
• Providers in Durham, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.