NPIMap

Organization Active NPI

Advocare, LLC

Doing business as Advocare Pediatric Medical Associates

  • Pediatrics Physician
  • Havertown, PA
National Provider Identifier
1265456875
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ADVOCARE, LLC
Doing business as
Advocare Pediatric Medical Associates
Practice address
420 W Township Line Rd
Havertown, PA 19083-5210
Phone
(610) 449-6200
Fax
(610) 449-0775
NPI assigned
Jul 27, 2006
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
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

420 W Township Line Rd
Havertown, PA 19083-5210

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
021601AOtherCLIA
101628997MedicaidPA

Other names 1

  • Advocare Pediatric Medical Associates Doing business as

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 19

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

View all 19

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": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561680000000",
    "number": "1265456875",
    "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": "420 W TOWNSHIP LINE RD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190835210",
            "telephone_number": "610-449-6200",
            "fax_number": "610-449-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVOCARE , LLC",
        "enumeration_date": "2006-07-27",
        "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": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "021601A",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101628997",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advocare Pediatric Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advocare Pediatric Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Havertown, PA

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.