NPIMap

Organization Active NPI

Private Diagnostic Clinic, PLLC

  • Physical Therapist
  • Durham, NC
National Provider Identifier
1124459292
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PRIVATE DIAGNOSTIC CLINIC, PLLC
Practice address
Duke Clinic 1E
40 Duke Medicine Circle
Durham, NC 27710-0001
Phone
(919) 668-1390
NPI assigned
Nov 27, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Authorized official

Name
Paul R Newman
Title
Executive Director, PDC
Phone
(919) 613-7652

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

Duke Clinic 1E
40 Duke Medicine Circle
Durham, NC 27710-0001

Mailing address

PO Box 110566
Durham, NC 27709-5566
Phone (919) 620-4855

Other names 1

  • DukePDCPTOT Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cabarrus Memorial Hospi23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652400000000",
    "number": "1124459292",
    "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": "DUKE CLINIC 1E",
            "address_2": "40 DUKE MEDICINE CIRCLE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277100001",
            "telephone_number": "919-668-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE DIAGNOSTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-27",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A",
        "authorized_official_last_name": "NEWMAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, PDC",
        "authorized_official_telephone_number": "919-613-7652"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DukePDCPTOT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DukePDCPTOT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

  • 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.