OrganizationActive
Private Diagnostic Clinic, PLLC
NPI 1962952093 · Prosthetic/Orthotic Supplier · Durham, NC
Provider details
- NPI number
- 1962952093
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Christopher Frederick, Practice Chief Financial Officer(919) 620-1055
Specialties & taxonomies
Suppliers
- Orthopaedic Surgery Physician207X00000X
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
Established profile(71/100 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
3609 Sw Durham Dr
Durham, NC 27707-6507
Phone: (919) 417-9622
Fax: (919) 477-1929
Street-level locationGet directions
Mailing address
Po Box 110566
Durham, NC 27709-5566
Other names (DBA / former)
- Doing business as
- North Carolina Orthopaedic Clinic
- Doing business as
- North Carolina Orthopaedic Clinic
Registry dates
- Enumerated
- 2016-10-13
- 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.