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ADVANCED PEDIATRICS PLLC
NPI 1962686865
Pediatrics in Vienna, VA

Active since December 27, 2007CLIA Certified · 2 labs
100 EAST ST SE, SUITE 301, VIENNA, VA 22180(703) 938-5555(703) 319-8580 Get Directions Write a Review

NPPES record last updated: December 27, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Advanced Pediatrics Pllc NPPES

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

ADVANCED PEDIATRICS PLLC (NPI 1962686865) is a healthcare organization registered as a pediatrics in Vienna, Virginia and active in the NPI registry since December 2007. The organization holds 2 active CLIA laboratory certificates and lists Lisa M Jackson, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1962686865
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameADVANCED PEDIATRICS PLLC
Location Address100 EAST ST SE, SUITE 301Vienna, VA 22180-4800
Mailing Address100 East St Se, Suite 301Vienna, VA 22180-4800 · (703) 938-5555 · Fax (703) 319-8580
Phone(703) 938-5555
Fax(703) 319-8580
Organization SubpartNo
Authorized OfficialLisa M JacksonOffice Manager · (703) 938-5555
Enumeration DateDecember 27, 2007
✔ NPI 1962686865 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
100 EAST ST SE, Vienna, VA 22180
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

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 Accreditation 49D0978862

Advanced Pediatrics · Vienna, VA
Active · expires Dec 10, 2026
CLIA Number49D0978862
Laboratory TypePhysician Office
Certificate Effective DateDecember 11, 2024
Certificate Expiration DateDecember 10, 2026
Laboratory DirectorDr. Christina Ulen
Laboratory Phone(703) 938-5555
Laboratory LocationAdvanced Pediatrics100 East Street, SE - Suite 301, Vienna, VA 22180
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 49D2016650

Advanced Pediatrics · Vienna, VA
Active · expires Nov 21, 2026
CLIA Number49D2016650
Laboratory TypePractitioner Other
Certificate Effective DateNovember 22, 2024
Certificate Expiration DateNovember 21, 2026
Laboratory DirectorChristina Ulen
Laboratory Phone(703) 935-8756
Laboratory LocationAdvanced Pediatrics100 East Street, SE , Suite 203, Vienna, VA 22180
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 6

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

DR. JINNY K YOO MD
Pediatrics
100 EAST ST SE, SUITE 301
VIENNA, VA 22180
Fairfax County (703) 938-5555
DR. ANDREA B WEAVER MD
Pediatrics
100 EAST ST SE, SUITE 301
VIENNA, VA 22180
Fairfax County (703) 938-5555
ANGELA BELL
Pediatrics
100 EAST ST SE
VIENNA, VA 22180
Fairfax County (703) 938-5555
MS. CARLA M MINOSH NP
Nurse Practitioner
100 EAST ST SE, SUITE 301
VIENNA, VA 22180
Fairfax County (703) 938-5555
PRIMARY MOTION, LLC
Clinic/Center (Physical Therapy)
100 EAST ST SE
VIENNA, VA 22180
Fairfax County (703) 652-7533
LORI L SCHUBERT RN, IBCLC
Registered Nurse (Lactation Consultant)
100 EAST ST SE, SUITE 301
VIENNA, VA 22180
Fairfax County (703) 938-5555

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 Advanced Pediatrics PLLC's NPI number?

The NPI number for Advanced Pediatrics PLLC is 1962686865. It was assigned to this organization in the NPPES registry on December 27, 2007.

Where is Advanced Pediatrics PLLC located?

Advanced Pediatrics PLLC is located at 100 East St SE Suite 301, Vienna, VA 22180. The listed phone number is (703) 938-5555.

What is Advanced Pediatrics PLLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Advanced Pediatrics PLLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Advanced Pediatrics PLLC was last updated on December 27, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.