Private Diagnostic Clinic, PLLC

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

PRIVATE DIAGNOSTIC CLINIC, PLLC

Doing business as

Carolina Family Practice & Sports Medicine-Cary

Practice address

3700 NW Cary Pkwy
Ste. 110
Cary, NC 27513-8446

Phone

(919) 238-2000

NPI assigned

Sep 19, 2012

Last updated

Jul 11, 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

Valla F Wilson

Title

Chief Compliance Privacy & Audit of

Phone

(919) 668-5161

Specialties & licenses 1

Addresses

Other names 1

• Carolina Family Practice & Sports Medicine-Cary Doing business as

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1437400280",
    "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": "3700 NW CARY PKWY",
            "address_2": "STE. 110",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138446",
            "telephone_number": "919-238-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE DIAGNOSTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-19",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "VALLA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE PRIVACY & AUDIT OF",
        "authorized_official_telephone_number": "919-668-5161"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Family Practice & Sports Medicine-Cary",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carolina Family Practice & Sports Medicine-Cary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Douglas Brian Pritchett, MD
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• Sports Medicine (Family Medicine) Physician in Cary, NC
• Providers in Cary, NC by specialty
• Sports Medicine (Family Medicine) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.