Private Diagnostic Clinic, PLLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

PRIVATE DIAGNOSTIC CLINIC, PLLC

Doing business as

Duke Neurosurgical Associates of Lumberton

Practice address

2936 N Elm St
Suite 101
Lumberton, NC 28358-2981

Phone

(919) 684-8111

NPI assigned

Jul 9, 2006

Last updated

May 15, 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 1

Addresses

Other identifiers 3

Other names 1

• Duke Neurosurgical Associates of Lumberton 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": "1652572800000",
    "number": "1225061427",
    "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": "2936 N ELM ST",
            "address_2": "SUITE 101",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582981",
            "telephone_number": "919-684-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE DIAGNOSTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2022-05-15",
        "certification_date": "2022-05-15",
        "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": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0228J",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE GRP",
            "identifier": "1029437026",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890228J",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duke Neurosurgical Associates of Lumberton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Duke Neurosurgical Associates of Lumberton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Surgery Physician in Lumberton, NC
• Providers in Lumberton, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.