IDEAL PEDIATRIC AND ADOLESCENT CARE
NPI 1154879096
Clinic/Center in Lewisburg, PA
NPI Status: Active since September 21, 2016
- Organization
- Clinic/Center
- CLIA Number: 39D2122703
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-04-2026
About IDEAL PEDIATRIC AND ADOLESCENT CARE
This page provides the complete NPI Profile along with additional information for Ideal Pediatric And Adolescent Care, a provider established in Lewisburg, Pennsylvania operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1154879096 assigned on September 2016. The practitioner's primary taxonomy code is 261Q00000X with license number OS008495L (PA). The provider is registered as an organization and their NPI record was last updated 9 years ago. The authorized official of this NPI record is Dr. Mary Beth Ann O'hara D.o. (President)
- NPI
- 1154879096
- Provider Name
- IDEAL PEDIATRIC AND ADOLESCENT CARE
- Entity Type
- Organization
- Location Address
- 121 JPM RD LEWISBURG, PA 17837
- Location Phone
- (570) 551-0300
- Mailing Address
- 121 JPM RD LEWISBURG, PA 17837
- Mailing Phone
- (570) 551-0300
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-21-2016
- Last Update Date
- 09-21-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- License No.
- OS008495L
- License State
- PA
- Taxonomy Description
- 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).
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 39D2122703
- Facility Type
- Physician Office
- Certificate Effective Date
- December 05, 2024
- Certificate Expiration Date
- December 04, 2026
- Laboratory Director
- DR. MARY BETH OHARA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Ideal Pediatric And Adolescent Care to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 5 | 4 | 8 | 7 | 9 | 0 | 9 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 10 | 4 | 16 | 7 | 18 | 0 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 0 + 4 + 1 + 6 + 7 + 1 + 8 + 0 + 1 + 8 + 24 = 64 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 64 = 6 | 6 | ||||||||
The NPI number 1154879096 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1790746576 | DR. MARY BETH ANN O'HARA DO Individual | Pediatrics | 121 JPM RD LEWISBURG, PA 17837 (570) 551-0300 |
| 1154889624 | EMILY E MOWRY CPNP Individual | Nurse Practitioner (Pediatrics) | 121 JPM RD LEWISBURG, PA 17837 (570) 551-0300 |
| 1447858808 | COURTNEY SEXTON CRNP, CPNP-PC Individual | Nurse Practitioner (Pediatrics) | 121 JPM RD LEWISBURG, PA 17837 (570) 551-0300 |
| 1619540366 | LYNDSI BORISOV CRNP Individual | Nurse Practitioner | 121 JPM RD LEWISBURG, PA 17837 (570) 531-0300 |
| 1114653912 | AMELIA ANN-MARIE SWARTZBAUGH CRNP Individual | Nurse Practitioner (Family) | 121 JPM RD LEWISBURG, PA 17837 (570) 551-0300 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154879096, enumerated in the NPI registry as an "organization" on September 21, 2016
The provider is located at 121 Jpm Rd Lewisburg, Pa 17837 and the phone number is (570) 551-0300
This medical organization specializes in Clinic/Center with taxonomy code 261Q00000X
The provider's CLIA number is 39D2122703 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on September 21, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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