Private Diagnostic Clinic, PLLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

PRIVATE DIAGNOSTIC CLINIC, PLLC

Doing business as

Southeastern Nephrology Assoc

Practice address

1302 Medical Center Dr
Wilmington, NC 28401-7503

Phone

(910) 763-4401

NPI assigned

Apr 18, 2011

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

Christopher Thomas Frederick

Title

Cfo

Phone

(919) 613-7762

Specialties & licenses 1

Addresses

Other names 1

• Southeastern Nephrology Assoc Doing business as

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1457641946",
    "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": "1302 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017503",
            "telephone_number": "910-763-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE DIAGNOSTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-18",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "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": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeastern Nephrology Assoc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southeastern Nephrology Assoc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danille Prime, M.D.
• Marilynn A Prince-Fiocco, MD
• Wendy Marie Principe, FNP
• Chiara Pringle-O'Neal
• Erika M Pritchett, MD
• Private Diagnostic Clinic, PLLC (Wilmington Maternal-Fetal Medicine)
• Pro-Health Behavioral Services PLLC
• Kirsten Lyndsey Probst-Santha
• Jeffrey Probst, PA-C
• Lindsey Hastings Prochaska, DO

• Nephrology Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Nephrology 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.