Active NPI
Private Diagnostic Clinic, PLLC
- Psychologist
- Durham, NC
National Provider Identifier
1649757568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Legal business name
- PRIVATE DIAGNOSTIC CLINIC, PLLC
- Practice address
- 40 Duke Medicine Cir
Durham, NC 27710-4000 - Phone
- (919) 620-4700
- NPI assigned
- Jul 24, 2018
- Organization subpart
- Yes
- Parent organization
- PRIVATE DIAGNOSTIC CLINIC, PLLC
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
40 Duke Medicine Cir
Durham, NC 27710-4000
Mailing address
PO Box 110566
Durham, NC 27709-5566
Phone (919) 620-4855
National Provider Directory
National Provider Directory- Part of
- Cabarrus Memorial Hospi
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532390400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1657497600000",
"number": "1649757568",
"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": "40 DUKE MEDICINE CIR",
"city": "DURHAM",
"state": "NC",
"postal_code": "277104000",
"telephone_number": "919-620-4700"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRIVATE DIAGNOSTIC CLINIC, PLLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PRIVATE DIAGNOSTIC CLINIC, PLLC",
"enumeration_date": "2018-07-24",
"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": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
- Private Diagnostic Clinic, PLLC
- Private Diagnostic Clinic, PLLC (Duke Outpatient Clinic)
- Private Diagnostic Clinic, PLLC (Harris & Smith OB-GYN)
- Private Diagnostic Clinic, PLLC (Duke Health Center at Duke St)
- Private Diagnostic Clinic, PLLC (Duke Medicine Circle Clinic)
- Private Diagnostic Clinic, PLLC
- Private Diagnostic Clinic, PLLC (North Carolina Orthopaedic Clinic)
- Private Diagnostic Clinic, PLLC (Duke Asthma, Allergy, Airway Center)
- Private Diagnostic Clinic, PLLC (Harris & Smith OB/GYN)
- Private Diagnostic Clinic, PLLC (Duke Primary and Specialty Care Services)
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.