Private Diagnostic Clinic, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PRIVATE DIAGNOSTIC CLINIC, PLLC

Practice address

95 Springbrook Ave
Suite 111
Clayton, NC 27520-8520

Phone

(910) 550-6133

NPI assigned

Mar 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Christopher T Frederick

Title

Cfo

Phone

(919) 620-4918

Specialties & licenses 1

Addresses

Other names 1

• Duke Health Center of Clayton Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1770600363",
    "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": "95 SPRINGBROOK AVE",
            "address_2": "SUITE 111",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275208520",
            "telephone_number": "910-550-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE DIAGNOSTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "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": "T",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "919-620-4918",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duke Health Center of Clayton",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Duke Health Center of Clayton",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dawn Janine Pretlow, DIALYSIS TECHNICIAN
• Alyssa Mae Price
• Primary Choice Home Care
• Prime Legacy Rehabilitation Services, PLLC
• Private Diagnostic Clinic, PLLC (University Orthopaedics and Sports Medicine of Clayton)
• Courtney Privette, COTAL
• Progressive Speech Solutions, PLLC
• Sara Elizabeth Prokup, PT, DPT
• Deborah Marisa Prouse, PA-C, ATC
• Haleigh Elizabeth Prysock, PA-C

• Internal Medicine Physician in Clayton, NC
• Providers in Clayton, NC by specialty
• Internal Medicine 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.
• 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.