Private Diagnostic Clinic, PLLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PRIVATE DIAGNOSTIC CLINIC, PLLC

Practice address

10441 Moncreiffe Rd
Suite 101
Raleigh, NC 27617-7810

Phone

(800) 266-3853

NPI assigned

Jan 25, 2007

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 2

Addresses

Other names 1

• Duke GI at Brier Creek Other name

Listed as

Private Diagnostic Clinic PLLCCCN 34C0001159

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rahul A Shimpi, MD

  • Gastroenterology Physician
  • Clayton, NC
  • NPI 1104034230
  NPD (past)

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1477609535",
    "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": "10441 MONCREIFFE RD",
            "address_2": "SUITE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276177810",
            "telephone_number": "800-266-3853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE DIAGNOSTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "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": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duke GI at Brier Creek",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Duke GI at Brier Creek",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Private Diagnostic Clinic, PLLC (Duke Orthopaedics of Raleigh)
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• Private Diagnostic Clinic, PLLC (Carolina Orthopaedics & Sports Medicine)
• Private Diagnostic Clinic, PLLC (West Raleigh Internal Medicine)
• Private Diagnostic Clinic, PLLC (Raleigh Pulmonary & Allergy Consultants)
• Private Diagnostic Clinic, PLLC (Capitol Pediatrics and Adolescent Center)
• Private Diagnostic Clinic, PLLC (Carolina Family Practice & Sports Medicine-Raleigh)
• Private Diagnostic Clinic, PLLC (Raleigh Neurosurgery at Cedarhurst)
• Private Diagnostic Clinic, PLLC (Duke Eye Center of Raleigh)

• Ambulatory Surgical Clinic/Center in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Ambulatory Surgical Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.