NPIMap

Organization Active NPI

Private Diagnostic Clinic, PLLC

Doing business as Duke Pulmonary, Allergy & Critical Care Medicine

  • Allergy & Immunology (Internal Medicine) Physician
  • Durham, NC
National Provider Identifier
1255364329
Registry record updated May 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X
Legal business name
PRIVATE DIAGNOSTIC CLINIC, PLLC
Doing business as
Duke Pulmonary, Allergy & Critical Care Medicine
Practice address
2609 N Duke St
Suite 504
Durham, NC 27704-3048
Phone
(919) 684-8111
NPI assigned
Jul 9, 2006
Last updated
May 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2022

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology (Internal Medicine) Physician 207RA0201X NU Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X NU
Pulmonary Disease Physician 207RP1001X NU

Addresses

Primary practice location

2609 N Duke St
Suite 504
Durham, NC 27704-3048

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
7907025MedicaidNC
07020OtherNCGRP

Other names 1

  • Duke Pulmonary, Allergy & Critical Care Medicine Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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": "1255364329",
    "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": "2609 N DUKE ST",
            "address_2": "SUITE 504",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277043048",
            "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": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7907025",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP",
            "identifier": "07020",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duke Pulmonary, Allergy & Critical Care Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Duke Pulmonary, Allergy & Critical Care Medicine",
            "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 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.