NPIMap

Organization Active NPI

Private Diagnostic Clinic, PLLC

Doing business as Duke Specialty Clinic Brier Creek

  • Gastroenterology Physician
  • Raleigh, NC
National Provider Identifier
1568694552
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
PRIVATE DIAGNOSTIC CLINIC, PLLC
Doing business as
Duke Specialty Clinic Brier Creek
Practice address
10441 Moncreiffe Rd
Suite 100
Raleigh, NC 27617-7810
Phone
(919) 405-2341
NPI assigned
Aug 10, 2009
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
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

10441 Moncreiffe Rd
Suite 100
Raleigh, NC 27617-7810

Mailing address

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

Other names 1

  • Duke Specialty Clinic Brier Creek Doing business as

National Provider Directory

National Provider Directory

Locations

10441 Moncreiffe Rd
Ste 100
Raleigh, NC 27617
Phone (919) 405-2341

NPI Registry JSON

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1568694552",
    "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 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276177810",
            "telephone_number": "919-405-2341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE DIAGNOSTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-10",
        "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": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duke Specialty Clinic Brier Creek",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Duke Specialty Clinic Brier Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, 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.