Private Diagnostic Clinic, PLLC

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

Legal business name

PRIVATE DIAGNOSTIC CLINIC, PLLC

Practice address

711 N Franklin St
Whiteville, NC 28472-3412

Phone

(919) 684-8111

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 1

Addresses

Other identifiers 2

Other names 1

• Donayre Cancer Center Other name

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1548316698",
    "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": "711 N FRANKLIN ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723412",
            "telephone_number": "919-684-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE DIAGNOSTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "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": "207RX0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "017XP",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904937",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Donayre Cancer Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Donayre Cancer Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• James Henry Pridgen, M.D.
• Primary Health Choice, Inc.
• Primary Health Choice, Inc.
• Harrison Prince, DPT
• William Watson Pringle, DDS
• Professional Ultrasound & Imaging
• Nathan Carr Pulkingham, MD
• Janice Allen Pulley, FNP-C, PMHNP-BC
• Pure in Hearts Connections
• Bhaskar Pusuluri, M.D.

• Medical Oncology Physician in Whiteville, NC
• Providers in Whiteville, NC by specialty
• Medical Oncology 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.