OrganizationActive
Licking Memorial Professional Corp
NPI 1083634414 · Pediatrics Physician · Newark, OH
Licking Memorial Professional Corp is a Pediatrics Physician organization in Newark, OH (NPI 1083634414).
Provider details
- NPI number
- 1083634414
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Robert Montagnese, Executive V.p.(740) 348-4000
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1865 Tamarack Rd
Newark, OH 43055-2305
Phone: (740) 348-4940
Fax: (740) 348-4948
Street-level locationGet directions
Mailing address
1865 Tamarack Rd
Newark, OH 43055-2305
Other names (DBA / former)
- Doing business as
- Licking Memorial Pediatrics
Registry dates
- Enumerated
- 2006-07-20
- Last updated
- 2020-08-22
Frequently asked questions
- What is Licking Memorial Professional Corp's NPI number?
- Licking Memorial Professional Corp's National Provider Identifier (NPI) is 1083634414, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Licking Memorial Professional Corp?
- Licking Memorial Professional Corp is classified in the NPPES registry as Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Licking Memorial Professional Corp located?
- Licking Memorial Professional Corp's practice location on file with NPPES is 1865 Tamarack Rd, Newark, OH 43055-2305.
- What is Licking Memorial Professional Corp's phone number?
- The practice phone number listed in the NPPES registry for Licking Memorial Professional Corp is (740) 348-4940.
- Who is the authorized official for Licking Memorial Professional Corp?
- The authorized official listed on Licking Memorial Professional Corp's NPPES record is Robert Montagnese, Executive V.p.. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Licking Memorial Professional Corp's NPI active?
- Yes — Licking Memorial Professional Corp's NPI (1083634414) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.