Private Diagnostic Clinic, PLLC
NPI 1538410386ActiveOrganization· Family Medicine, Sports Medicine· Raleigh, NC
Family Medicine, Sports Medicine in Raleigh, North Carolina, registered in NPPES in September 2012. The authorized official on file is Christopher Thomas Frederick, Cfo.
Overview
| NPI | 1538410386 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 19, 2012 |
| Last updated in NPPES | Jul 11, 2022 |
| Certified by provider | Jul 11, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine, Sports Medicine Primary | 207QS0010X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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