Ideal Pediatric and Adolescent Care

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

OS008495L Issued in PA

Legal business name

IDEAL PEDIATRIC AND ADOLESCENT CARE

Practice address

121 JPM Rd
Lewisburg, PA 17837-9313

Phone

(570) 551-0300

NPI assigned

Sep 21, 2016

Last updated

Sep 21, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mary Beth Ann O'Hara, D.O.NPI 1790746576

Title

President

Phone

(570) 551-0300

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Practitioners 7

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.

• Mary Beth Ann O'Hara, DO

  • Pediatrics Physician
  • Lewisburg, PA
  • NPI 1790746576
  Authorized official Same address or phone
• Courtney Slater, CRNP, CPNP-PC

  • Pediatric Nurse Practitioner
  • Phoenixville, PA
  • NPI 1447858808
  NPD
• Amelia Ann-Marie Swartzbaugh, CRNP

  • Family Nurse Practitioner
  • Lewisburg, PA
  • NPI 1114653912
  NPD
• Jennifer Marie Hannon, PA-C

  • Physician Assistant
  • Hughesville, PA
  • NPI 1235589813
  NPD (past)
• Jennifer Lynn Mitchell, PA-C

  • Physician Assistant
  • Coal Township, PA
  • NPI 1811538598

  Multi-Specialty

  NPD (past)
• Emily E Mowry, CPNP

  • Pediatric Nurse Practitioner
  • Lewisburg, PA
  • NPI 1154889624
  NPD (past)
• Nancy M Branch, PNP

  • Pediatric Nurse Practitioner
  • Trenton, NJ
  • NPI 1134642036
  NPD (past)

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1154879096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 JPM RD",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379313",
            "telephone_number": "570-551-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 JPM RD",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379313",
            "telephone_number": "570-551-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL PEDIATRIC AND ADOLESCENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-21",
        "last_updated": "2016-09-21",
        "status": "A",
        "authorized_official_last_name": "O'HARA",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-551-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": "OS008495L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Hughes, RN, BSN, CDE
• Jennifer Marie Hunt
• Lynn Hunter, CRNP
• Holly Hurley
• Justine E. Ianneillo, LMT
• Ideal Speech Solutions LLC
• Margaret Inglis, RN
• Amy Inram, MSOTR/L
• Inspire Medical Equipment and Services, Inc.
• Institutional Eye Care

• Clinic/Center in Lewisburg, PA
• Providers in Lewisburg, PA by specialty
• Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.