NPIMap

Organization Active NPI

Private Diagnostic Clinic, PLLC

Doing business as Duke Outpatient Clinic

  • Internal Medicine Physician
  • Durham, NC
National Provider Identifier
1528247996
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PRIVATE DIAGNOSTIC CLINIC, PLLC
Doing business as
Duke Outpatient Clinic
Practice address
4220 N Roxboro St
Durham, NC 27704-1826
Phone
(919) 471-8344
NPI assigned
Nov 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4220 N Roxboro St
Durham, NC 27704-1826

Mailing address

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

Other names 1

  • Duke Outpatient Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Surgical Priv Diag Clinic23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1528247996",
    "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": "4220 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277041826",
            "telephone_number": "919-471-8344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE DIAGNOSTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-01",
        "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": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duke Outpatient Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Duke Outpatient Clinic",
            "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 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.