Private Diagnostic Clinic, PLLC

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

Legal business name

PRIVATE DIAGNOSTIC CLINIC, PLLC

Practice address

812 Candy Park Rd
Pembroke, NC 28372-9129

Phone

(910) 671-5730

NPI assigned

Jun 4, 2010

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 names 1

• Southeastern Cancer-Pembroke Doing business as

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652572800000",
    "number": "1235459926",
    "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": "812 CANDY PARK RD",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283729129",
            "telephone_number": "910-671-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE DIAGNOSTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-04",
        "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": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeastern Cancer-Pembroke",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southeastern Cancer-Pembroke",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Positive Progress Services Corp.
• Deidre Chavis Powell, FNP-C
• Nancy G Powell
• Susanna Poyer
• Private Diagnostic Clinic, PLLC
• Promptcare Clinic, PLLC
• Pure Faith Home Care LLC
• Pure Faith Home Care LLC
• Quality Care Home Health Inc
• Quality Comfort Care LLC

• Hematology & Oncology Physician in Pembroke, NC
• Providers in Pembroke, NC by specialty
• Hematology & Oncology 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.