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IDEAL PEDIATRIC AND ADOLESCENT CARE
NPI 1154879096
Clinic/Center in Lewisburg, PA

Active since September 21, 2016CLIA 39D2122703 · Waiver
121 JPM RD, LEWISBURG, PA 17837(570) 551-0300 Get Directions Write a Review

NPPES record last updated: September 21, 2016. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Ideal Pediatric And Adolescent Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IDEAL PEDIATRIC AND ADOLESCENT CARE (NPI 1154879096) is a healthcare organization registered as a clinic/center in Lewisburg, Pennsylvania and active in the NPI registry since September 2016. The organization holds a CLIA Waiver certificate valid through December 4, 2026 and lists Mary Beth Ann O'hara, President, as its authorized official.

NPPES Registry Identity

NPI1154879096
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameIDEAL PEDIATRIC AND ADOLESCENT CARE
Location Address121 JPM RDLewisburg, PA 17837-9313
Mailing Address121 Jpm RdLewisburg, PA 17837-9313 · (570) 551-0300
Phone(570) 551-0300
Organization SubpartNo
Authorized OfficialMary Beth Ann O'haraPresident · (570) 551-0300
Enumeration DateSeptember 21, 2016
✔ NPI 1154879096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in PA · OS008495L
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
121 JPM RD, Lewisburg, PA 17837
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D2122703

Ideal Pediatric And Adolescent Care, PC · Lewisburg, PA
Active · expires Dec 4, 2026
CLIA Number39D2122703
Laboratory TypePhysician Office
Certificate Effective DateDecember 5, 2024
Certificate Expiration DateDecember 4, 2026
Laboratory DirectorDr. Mary Beth Ohara
Laboratory Phone(571) 551-0300
Laboratory LocationIdeal Pediatric And Adolescent Care, PC121 Jpm Road, Lewisburg, PA 17837
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMELIA ANN-MARIE SWARTZBAUGH CRNP
Nurse Practitioner (Family)
121 JPM RD
LEWISBURG, PA 17837
Union County (570) 551-0300
EMILY E MOWRY CPNP
Nurse Practitioner (Pediatrics)
121 JPM RD
LEWISBURG, PA 17837
Union County (570) 551-0300
LYNDSI BORISOV CRNP
Nurse Practitioner
121 JPM RD
LEWISBURG, PA 17837
Union County (570) 531-0300
DR. MARY BETH ANN O'HARA DO
Pediatrics
121 JPM RD
LEWISBURG, PA 17837
Union County (570) 551-0300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ideal Pediatric And Adolescent Care's NPI number?

The NPI number for Ideal Pediatric And Adolescent Care is 1154879096. It was assigned to this organization in the NPPES registry on September 21, 2016.

Where is Ideal Pediatric And Adolescent Care located?

Ideal Pediatric And Adolescent Care is located at 121 Jpm Rd, Lewisburg, PA 17837. The listed phone number is (570) 551-0300.

What is Ideal Pediatric And Adolescent Care's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Ideal Pediatric And Adolescent Care hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D2122703) is associated with this NPI, valid through December 4, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ideal Pediatric And Adolescent Care was last updated on September 21, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.