NPIMap

Organization Active NPI

Advocare, LLC

Doing business as Advocare Main Line Pediatrics

  • Pediatrics Physician
  • Penn Valley, PA
National Provider Identifier
1326050394
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ADVOCARE, LLC
Doing business as
Advocare Main Line Pediatrics
Practice address
701 Montgomery Ave
Suite 18
Penn Valley, PA 19072-2036
Phone
(610) 642-9200
Fax
(610) 649-4723
NPI assigned
Aug 11, 2006
Last updated
Nov 22, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVOCARE , LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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 Primary

Addresses

Primary practice location

701 Montgomery Ave
Suite 18
Penn Valley, PA 19072-2036

Mailing address

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

Other names 1

  • Advocare Main Line Pediatrics 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
39D0202342Advocare Main Line Pediatrics701 Montgomery Avenue, Narberth, PA 19072Certificate of waiverDec 30, 2026

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 22

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

View all 22

Locations

2000 Hamilton St
Ste 109
Philadelphia, PA 19130
Phone (215) 774-1166

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": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1326050394",
    "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",
            "fax_number": "856-504-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MONTGOMERY AVE",
            "address_2": "SUITE 18",
            "city": "PENN VALLEY",
            "state": "PA",
            "postal_code": "190722036",
            "telephone_number": "610-642-9200",
            "fax_number": "610-649-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVOCARE , LLC",
        "enumeration_date": "2006-08-11",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advocare Main Line Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advocare Main Line Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Penn Valley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.