OrganizationActive
Licking Memorial Professional Corp.
NPI 1669547824 · Pediatrics Physician · Newark, OH
Licking Memorial Professional Corp. is a Pediatrics Physician organization in Newark, OH (NPI 1669547824).
Provider details
- NPI number
- 1669547824
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Robert Montagnese, Credentialing Coordinator(740) 348-4027
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 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
399 E Main St
Newark, OH 43055-6516
Phone: (740) 348-1840
Fax: (740) 348-1841
Street-level locationGet directions
Mailing address
399 E Main St
Newark, OH 43055-6516
Other names (DBA / former)
- Doing business as
- Licking Memorial Pediatrics East
Registry dates
- Enumerated
- 2006-11-22
- 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 1669547824, 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 399 E Main St, Newark, OH 43055-6516.
- 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) 348-1840.
- 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, Credentialing Coordinator. 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 (1669547824) 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.