Active NPI
Private Diagnostic Clinic, PLLC
Doing business as Growing Child Pediatrics
- Pediatrics Physician
- Raleigh, NC
National Provider Identifier
1316455728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 23168
- Legal business name
- PRIVATE DIAGNOSTIC CLINIC, PLLC
- Doing business as
- Growing Child Pediatrics
- Practice address
- 7990 Arco Corporate Dr
Raleigh, NC 27617-2029 - Phone
- (919) 544-5900
- NPI assigned
- Jan 19, 2018
- Last updated
- May 15, 2022
- Organization subpart
- Yes
- Parent organization
- PRIVATE DIAGNOSTIC CLINIC PLLC
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 23168 | NC | |
| Pediatrics Physician | 208000000X | 23168 | NC | Primary |
Addresses
Primary practice location
7990 Arco Corporate Dr
Raleigh, NC 27617-2029
Mailing address
PO Box 110566
Durham, NC 27709-5566
Phone (919) 620-4855
Other practice location 1
1005 Big Oak Ct
Knightdale, NC 27545-6565
Phone (919) 266-5669
Other practice location 2
500 Gateway Dr
Clayton, NC 27520-2158
Phone (919) 585-9001
Other practice location 3
116 E Horton St
Zebulon, NC 27597-2820
Phone (919) 269-2885
Other practice location 4
11130 Capital Blvd
Wake Forest, NC 27587-4513
Phone (919) 488-4094
Other practice location 5
270 Horizon Dr
Raleigh, NC 27615-4922
Phone (919) 845-0623
Other names 1
- Growing Child Pediatrics
National Provider Directory
National Provider Directory- Part of
- Surgical Priv Diag Clinic
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516320000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1652572800000",
"number": "1316455728",
"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": "7990 ARCO CORPORATE DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276172029",
"telephone_number": "919-544-5900"
}
],
"practiceLocations": [
{
"address_1": "1005 Big Oak Ct",
"address_purpose": "LOCATION",
"city": "Knightdale",
"state": "NC",
"postal_code": "275456565",
"country_code": "US",
"telephone_number": "919-266-5669",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "500 Gateway Dr",
"address_purpose": "LOCATION",
"city": "Clayton",
"state": "NC",
"postal_code": "275202158",
"country_code": "US",
"telephone_number": "919-585-9001",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "116 E Horton St",
"address_purpose": "LOCATION",
"city": "Zebulon",
"state": "NC",
"postal_code": "275972820",
"country_code": "US",
"telephone_number": "919-269-2885",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11130 Capital Blvd",
"address_purpose": "LOCATION",
"city": "Wake Forest",
"state": "NC",
"postal_code": "275874513",
"country_code": "US",
"telephone_number": "919-488-4094",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "270 Horizon Dr",
"address_purpose": "LOCATION",
"city": "Raleigh",
"state": "NC",
"postal_code": "276154922",
"country_code": "US",
"telephone_number": "919-845-0623",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "PRIVATE DIAGNOSTIC CLINIC, PLLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PRIVATE DIAGNOSTIC CLINIC PLLC",
"enumeration_date": "2018-01-19",
"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": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "23168",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "23168",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Growing Child Pediatrics",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Raleigh, NC
- Private Diagnostic Clinic, PLLC (Duke Hematology /Oncology @Duke Health Raleigh Hospital)
- Private Diagnostic Clinic, PLLC (Duke Surgical Oncology of Raleigh)
- Private Diagnostic Clinic, PLLC (Duke Raleigh Hospital (PDC))
- Private Diagnostic Clinic, PLLC (Duke Urology of Raleigh)
- Private Diagnostic Clinic, PLLC (Carolina Women's Health)
- Private Diagnostic Clinic, PLLC (Carolina Orthopaedics and Sports Medicine)
- Private Diagnostic Clinic, PLLC (Duke Children's Specialty Services)
- Private Diagnostic Clinic, PLLC (Duke Endoscopy of Raleigh)
- Private Diagnostic Clinic, PLLC (Duke Orthopedics of Raleigh)
- Private Diagnostic Clinic, PLLC (Duke Women's Health Brier Creek)
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.