OrganizationActive
Private Diagnostic Clinic, PLLC
NPI 1538410386 · Sports Medicine (Family Medicine) Physician · Raleigh, NC
Provider details
- NPI number
- 1538410386
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Christopher Frederick, Cfo(919) 613-7762
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
8300 Health Park
Ste. 107
Raleigh, NC 27615-4730
Phone: (919) 238-2000
Street-level locationGet directions
Mailing address
Po Box 110566
Durham, NC 27709-5566
Other names (DBA / former)
- Doing business as
- Carolina Family Practice & Sports Medicine-Raleigh
- Doing business as
- Carolina Family Practice & Sports Medicine-Raleigh
Registry dates
- Enumerated
- 2012-09-19
- Last updated
- 2022-07-11
- Certified
- 2022-07-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.