LICKING MEMORIAL ENDOCRINOLOGY
NPI 1073822938
Internal Medicine - Endocrinology, Diabetes & Metabolism in Newark, OH

Active since September 27, 2010CLIA 36D2043631 · Waiver
1272 W MAIN ST, BLDG 2 STE 3, NEWARK, OH 43055(740) 348-7950(740) 348-7951 Get Directions Write a Review

NPPES record last updated: July 31, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Licking Memorial Endocrinology NPPES

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

LICKING MEMORIAL ENDOCRINOLOGY (NPI 1073822938) is a healthcare organization registered as an endocrinology, diabetes & metabolism in Newark, Ohio and active in the NPI registry since September 2010. The organization holds a CLIA Waiver certificate valid through July 5, 2028 and lists Cynthia L Webster, Vp Of Financial Services, as its authorized official.

NPPES Registry Identity

NPI1073822938
Entity TypeOrganization
Primary Taxonomy207RE0101X
Legal Business NameLICKING MEMORIAL PROFESSIONAL CORP
Location Address1272 W MAIN ST, BLDG 2 STE 3Newark, OH 43055-2004
Mailing Address1272 W Main St, Bldg 2 Ste 3Newark, OH 43055-2004 · (740) 348-7950 · Fax (740) 348-7951
Fax(740) 348-7951
Organization SubpartNo
Authorized OfficialCynthia L WebsterVp Of Financial Services · (740) 348-4518
Enumeration DateSeptember 27, 2010
Last NPPES UpdateJuly 31, 2012
NPI 1073822938 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

1272 W MAIN ST, Newark, OH 43055

Other Names 1

Doing Business AsLicking Memorial Endocrinology

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

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 36D2043631

Licking Memorial Endocrinology · Newark, OH
Active · expires Jul 5, 2028
CLIA Number36D2043631
Laboratory TypePhysician Office
Certificate Effective DateJuly 6, 2026
Certificate Expiration DateJuly 5, 2028
Laboratory DirectorGurunanthan Palani
Laboratory Phone(220) 564-1740
Laboratory LocationLicking Memorial Endocrinology1272 W Main St Suite 204, Newark, OH 43055
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 10

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

Family Medicine
1272 W MAIN ST, BLDG. 5
NEWARK, OH 43055
Podiatrist (Foot & Ankle Surgery)
1272 W MAIN ST, BUILDING #4
NEWARK, OH 43055
Pharmacy (Community/Retail Pharmacy)
1272 W MAIN ST
NEWARK, OH 43055
Family Medicine
1272 W MAIN ST, BLDG. 1
NEWARK, OH 43055
Surgery
1272 W MAIN ST, BLDG. 3
NEWARK, OH 43055
Surgery
1272 W MAIN ST, BLDG. 3
NEWARK, OH 43055
Family Medicine
1272 W MAIN ST, SUITE 503
NEWARK, OH 43055
Surgery (Plastic and Reconstructive Surgery)
1272 W MAIN ST, BLDG. 2
NEWARK, OH 43055

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 Licking Memorial Professional Corp's NPI number?

The NPI number for Licking Memorial Professional Corp is 1073822938. It was assigned to this organization in the NPPES registry on September 27, 2010. The provider is doing business as Licking Memorial Endocrinology.

Where is Licking Memorial Professional Corp located?

Licking Memorial Professional Corp is located at 1272 W Main St Bldg 2 Ste 3, Newark, OH 43055. The listed phone number is (740) 348-7950.

What is Licking Memorial Professional Corp's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Does Licking Memorial Professional Corp hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2043631) is associated with this NPI, valid through July 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Licking Memorial Professional Corp was last updated on July 31, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.