OrganizationActive

Private Diagnostic Clinic

NPI 1639617392 · Primary Care Clinic/Center · Raleigh, NC

Provider details

NPI number: 1639617392
Entity type: Organization
Primary specialty: Primary Care Clinic/CenterAmbulatory Health Care Facilities
Organization subpart: No
Authorized official: Kenni Watkins, Finanical Care Counslor(919) 307-0301
License: 1881778785 (NC)

Specialties & taxonomies

Primary Care Clinic/CenterPrimary261QP2300XLicense 1447306113 (NC)
Ambulatory Health Care Facilities
Primary Care Clinic/Center261QP2300XLicense 1881778785 (NC)
Ambulatory Health Care Facilities
Primary Care Clinic/Center261QP2300XLicense 1760566624 (NC)
Ambulatory Health Care Facilities
Primary Care Clinic/Center261QP2300XLicense 1386819795 (NC)
Ambulatory Health Care Facilities
Primary Care Clinic/Center261QP2300XLicense 1134395114 (NC)
Ambulatory Health Care Facilities
Primary Care Clinic/Center261QP2300XLicense 1598007866 (NC)

Profile Score

Established profile(70/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
9 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

10211 Alm St

Suite 200

Raleigh, NC 27617-8221

Phone: (919) 307-0301

Fax: (919) 307-0323

Street-level locationGet directions

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Mailing address