DUKE SPORTS MEDICINE CENTER CLINIC (PRIVATE DIAGNOSTIC CLINIC, PLLC) NPI 1144632894

Orthopaedic Surgery in Durham, NC

NPI 1144632894 Organization Orthopaedic Surgery CLIA Number 34D2013584 CLIA Certificate of Waiver

About DUKE SPORTS MEDICINE CENTER CLINIC (PRIVATE DIAGNOSTIC CLINIC, PLLC)

Duke Sports Medicine Center Clinic (private Diagnostic Clinic, Pllc) is a provider established in Durham, North Carolina specializing in orthopaedic surgery. The NPI number of Duke Sports Medicine Center Clinic (private Diagnostic Clinic, Pllc) is 1144632894 and was assigned on May 2014. The practitioner's primary taxonomy code is 207X00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. Duke Sports Medicine Center Clinic (private Diagnostic Clinic, Pllc) operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Duke Sports Medicine Center Clinic. The authorized official of this NPI record is Christopher T Frederick (Practice Chief Financial Officer)

The CLIA number of Duke Sports Medicine Center Clinic is 34D2013584 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Duke Sports Medicine Center Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1144632894

Provider NameDUKE SPORTS MEDICINE CENTER CLINIC (PRIVATE DIAGNOSTIC CLINIC, PLLC)
Provider Location Address3475 ERWIN RD DURHAM, NC 27705
Provider Mailing AddressPO BOX 63362 CHARLOTTE, NC 28263
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameDUKE SPORTS MEDICINE CENTER CLINIC
Other Name TypeDoing Business As (3)
Enumeration Date05-29-2014
Last Update Date08-09-2016


Primary Taxonomy

Taxonomy Code207X00000X
ClassificationOrthopaedic Surgery
TypeAllopathic & Osteopathic Physicians
Taxonomy DescriptionAn orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Business Address

DUKE SPORTS MEDICINE CENTER CLINIC
3475 ERWIN RD
DURHAM, NC
ZIP 27705
Phone: (919) 684-5888

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Mailing Address

DUKE SPORTS MEDICINE CENTER CLINIC
PO BOX 63362
CHARLOTTE, NC
ZIP 28263
Phone: (919) 684-8111



Authorized Official

Authorized Official Name CHRISTOPHER T FREDERICK
Authorized Official TitlePRACTICE CHIEF FINANCIAL OFFICER
Authorized Official Phone(919) 620-1055

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1144632894 is:

CLIA Number34D2013584
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Group Taxonomy


193200000X MULTI-SPECIALTY GROUP - This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineNo

Taxonomy Description: an orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
0319860034MEDICARE NSC (07)

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1629397740 JESSICA PSUJEK WAKEFIELD LPC
Individual
Counselor (Professional)3475 ERWIN RD
DURHAM, NC 27705
(919) 660-6731
1407996176 ILYA M LEYNGOLD MD
Individual
Ophthalmology (Ophthalmic Plastic and Reconstructive Surgery)3475 ERWIN RD
DURHAM, NC 27705
(919) 684-4224
1831114040 JUSTIN R LYNCH PA-C
Individual
Physician Assistant3475 ERWIN RD
DURHAM, NC 27705
(919) 668-1400
1730625401 TYLER COPE ATC, DPT
Individual
Physical Therapist (Sports)3475 ERWIN RD
DURHAM, NC 27705
(919) 681-1656
1659818870DR. DANNY ARORA MD, FRCSC
Individual
Orthopaedic Surgery (Sports Medicine)3475 ERWIN RD
DURHAM, NC 27705
(647) 882-2557
1134355860 ANDREA G HOFF PT
Individual
Physical Therapist3475 ERWIN RD PEPSICO BUILDING - 2ND FLOOR
DURHAM, NC 27705
(919) 681-1656
1851831945 THOMAS WILLAUER
Individual
Physical Therapist3475 ERWIN RD
DURHAM, NC 27705
(919) 668-1656
1477093581DR. BRIAN WURZINGER DPT, ATC
Individual
Physical Therapist (Sports)3475 ERWIN RD PEPSICO BUILDING
DURHAM, NC 27705
(919) 681-1656
1730620782 DANIEL LEE SAWYERS PT, CSCS
Individual
Physical Therapist3475 ERWIN RD PEPSICO BUILDING - PHYSICAL THERAPY
DURHAM, NC 27705
(919) 681-1656
1760923619 GARY EUGENE JOHNSON DPT
Individual
Physical Therapist3475 ERWIN RD
DURHAM, NC 27705
(919) 681-1656
1982145868 MICHAEL ESSA II
Individual
Physical Therapist3475 ERWIN RD DUMC BOX 3965
DURHAM, NC 27705
(919) 681-1656
1760913719 MICHAEL ROBERT MURRAY PT, DPT
Individual
Physical Therapist3475 ERWIN RD PEPSICO BUILDING
DURHAM, NC 27705
(919) 681-1656
1720510621 TREVOR MATULYS PT
Individual
Physical Therapist3475 ERWIN RD PEPSICO BUILDING
DURHAM, NC 27705
(919) 681-1656
1376072868MRS. HEIDI ROACH ATC
Individual
Specialist/Technologist (Athletic Trainer)3475 ERWIN RD
DURHAM, NC 27705
(919) 684-0493
1336652866 CIARA BURGI
Individual
Physical Therapist3475 ERWIN RD
DURHAM, NC 27705
(919) 681-1656
1083109227 CHRISTOPHER B D'ERRICO MS, ATC, LAT
Individual
Specialist/Technologist (Athletic Trainer)3475 ERWIN RD
DURHAM, NC 27705
(919) 684-5888
1922234640 ALANNA COOLEY BAKER PT
Individual
Physical Therapist3475 ERWIN RD
DURHAM, NC 27705
(919) 681-1656
1811123490 JAIME L BLANTON PT
Individual
Physical Therapist3475 ERWIN RD
DURHAM, NC 27705
(919) 681-1656
1962713412MS. LAURA STANLEY PIETROSIMONE PT, DPT, PHD, SCS
Individual
Physical Therapist3475 ERWIN RD
DURHAM, NC 27705
(919) 681-1656
1699253252MR. CHRISTOPHER RICHARD LEFEVER PT, DPT, SCS, CSCS
Individual
Physical Therapist3475 ERWIN RD
DURHAM, NC 27705
(610) 413-9223

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.