NPIMap

Organization Active NPI

Advocare , LLC

Doing business as Advocare Heritage Family Medicine

  • Family Medicine Physician
  • Moorestown, NJ
National Provider Identifier
1053589515
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ADVOCARE , LLC
Doing business as
Advocare Heritage Family Medicine
Practice address
703 E Main St
Suite 9
Moorestown, NJ 08057-3082
Phone
(856) 235-0290
Fax
(856) 795-1213
NPI assigned
Feb 18, 2008
Last updated
Jun 28, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVOCARE , LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Charles McQueary
Title
Executive Vice President and Coo
Phone
(856) 872-7055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

703 E Main St
Suite 9
Moorestown, NJ 08057-3082

Mailing address

401 Route 73 N Ste 320
Marlton, NJ 08053-3426
Phone (856) 872-7055

Other identifiers 3

IdentifierTypeStateIssuer
0153851MedicaidNJ
31D0118841OtherCLIA
31D0118841OtherNJCLIA

Other names 1

  • Advocare Heritage Family Medicine Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0118841Advocare Heritage Family Medicine703 E Main Street East Suite 9, Moorestown, NJ 08057Certificate of waiverMar 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Advocare LLC250 organizations share this tax ID, including this one
Part of
Advocare LLC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2201 Chapel Ave W
#435
Cherry Hill, NJ 08002

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561680000000",
    "number": "1053589515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ROUTE 73 N STE 320",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533426",
            "telephone_number": "856-872-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 E MAIN ST",
            "address_2": "SUITE 9",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573082",
            "telephone_number": "856-235-0290",
            "fax_number": "856-795-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCARE , LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVOCARE , LLC",
        "enumeration_date": "2008-02-18",
        "last_updated": "2019-06-28",
        "status": "A",
        "authorized_official_last_name": "MCQUEARY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT AND COO",
        "authorized_official_telephone_number": "856-872-7055"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0153851",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "31D0118841",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "31D0118841",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advocare Heritage Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advocare Heritage Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moorestown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.