Private Diagnostic Clinic, PLLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

PRIVATE DIAGNOSTIC CLINIC, PLLC

Doing business as

Duke Anesthesia of Person County

Practice address

615 Ridge Rd
Suite 202
Roxboro, NC 27573-4629

Phone

(919) 684-8111

NPI assigned

Jul 9, 2006

Last updated

May 13, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christopher Thomas Frederick

Title

Cfo

Phone

(919) 613-7762

Specialties & licenses 2

Addresses

Other names 1

• Duke Anesthesia of Person County Doing business as

Locations

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652400000000",
    "number": "1154354322",
    "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": "615 RIDGE RD",
            "address_2": "SUITE 202",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275734629",
            "telephone_number": "919-684-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE DIAGNOSTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "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": "THOMAS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "919-613-7762"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duke Anesthesia of Person County",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Duke Anesthesia of Person County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Private Diagnostic Clinic, PLLC (Duke Orthopaedics of Person County)
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• Private Diagnostic Clinic, PLLC (Harris & Smith OB/GYN - Roxboro)
• Private Diagnostic Clinic, PLLC (Duke Otolaryngology of Person County)
• Prodigious Health Services, LLC
• Program Resource Institute

• Anesthesiology Physician in Roxboro, NC
• Providers in Roxboro, NC by specialty
• Anesthesiology Physician 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.