Private Diagnostic Clinic, PLLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

PRIVATE DIAGNOSTIC CLINIC, PLLC

Doing business as

Duke Specialty Butner-Creedmoor

Practice address

2503 E Lyon Station Rd
Suite 200
Creedmoor, NC 27522-9112

Phone

(919) 528-1535

NPI assigned

Sep 29, 2010

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 names 1

• Duke Specialty Butner-Creedmoor Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ivy P Altomare, MD

  • Hematology & Oncology Physician
  • Durham, NC
  • NPI 1609063254
  NPD (past)
• Jonathan Stiber, M.D.

  • Cardiovascular Disease Physician
  • Durham, NC
  • NPI 1295819167
  NPD (past)
• Linda M Sutton, MD

  • Medical Oncology Physician
  • Roxboro, NC
  • NPI 1366409575
  NPD (past)

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1811206527",
    "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": "2503 E LYON STATION RD",
            "address_2": "SUITE 200",
            "city": "CREEDMOOR",
            "state": "NC",
            "postal_code": "275229112",
            "telephone_number": "919-528-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE DIAGNOSTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-29",
        "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": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duke Specialty Butner-Creedmoor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Duke Specialty Butner-Creedmoor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason Michael Pesqueira, M.D.
• Robin Peterson, NP
• Pinnacle Community Foundation
• Pinnacle Counseling Services, PLLC
• Premier Eye Institute, OD, PLLC
• Tonya Fisher Pruitt, FNP
• Quality Faith Home Care Agency, LLC
• Tarrelle Crews Reade, PMHNP, DNP, RN
• Desiree Reed, HEALTH COACH
• Reflective Counseling Services, PLLC

• Cardiovascular Disease Physician in Creedmoor, NC
• Providers in Creedmoor, NC by specialty
• Cardiovascular Disease 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.