SOUTHEASTERN NEPHROLOGY ASSOC – NPI #1457641946
Internal Medicine

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Health Care Provider Taxonomy Code for Internal Medicine

SOUTHEASTERN NEPHROLOGY ASSOC is a provider located in WILMINGTON, NC. NPPES has assigned the NPI number 1457641946 to SOUTHEASTERN NEPHROLOGY ASSOC on April 18, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SOUTHEASTERN NEPHROLOGY ASSOC” is a dba name, the actual legal business name for this organization is PRIVATE DIAGNOSTIC CLINIC, PLLC. The primary taxonomy selected by this provider is 207RN0300X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Nephrology

The NPI profile was previously updated about 4 years ago on Jul 11, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOUTHEASTERN NEPHROLOGY ASSOC below.

NPI Profile for
PRIVATE DIAGNOSTIC CLINIC, PLLC

NPI Number
1457641946
Enumeration Date

(more than 15 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PRIVATE DIAGNOSTIC CLINIC, PLLC
Doing Business As (dba): SOUTHEASTERN NEPHROLOGY ASSOC
Primary location
1302 MEDICAL CENTER DR
WILMINGTON, NC 28401-7503
Phone: (910) 763-4401 Fax:
Mailing address
PO BOX 110566
DURHAM, NC 27709-5566
Phone: (919) 620-4855 Fax: (919) 620-4921
Organization Subpart
No
Authorized Official
CHRISTOPHER FREDERICK
CFO
Phone: (919) 613-7762
Updated
Certification Date
Jul 11, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RN0300X
- Internal Medicine / Nephrology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.