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LICKING MEMORIAL FAMILY PRACTICE HEATH
NPI 1487688545
Family Medicine in Heath, OH

Active since July 11, 2006CLIA 36D1036911 · Waiver
687 HOPEWELL DR, SUITE2, HEATH, OH 43056(740) 348-7915(740) 348-7916 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Licking Memorial Family Practice Heath NPPES

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

LICKING MEMORIAL FAMILY PRACTICE HEATH (NPI 1487688545) is a healthcare organization registered as a family medicine in Heath, Ohio and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through March 21, 2028 and lists Robert A. Montagnese, Executive V.p., as its authorized official.

NPPES Registry Identity

NPI1487688545
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLICKING MEMORIAL PROFESSIONAL CORP.
Location Address687 HOPEWELL DR, SUITE2Heath, OH 43056-1579
Mailing Address687 Hopewell Dr, Suite2Heath, OH 43056-1579 · (740) 348-7915 · Fax (740) 348-7916
Phone(740) 348-7915
Fax(740) 348-7916
Organization SubpartNo
Authorized OfficialRobert A. MontagneseExecutive V.p. · (740) 348-4000
Enumeration DateJuly 11, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1487688545 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
687 HOPEWELL DR, Heath, OH 43056
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Other Names 1

Doing Business AsLicking Memorial Family Practice Heath

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 36D1036911

Licking Memorial Family Practice Heath · Heath, OH
Active · expires Mar 21, 2028
CLIA Number36D1036911
Laboratory TypePhysician Office
Certificate Effective DateMarch 22, 2026
Certificate Expiration DateMarch 21, 2028
Laboratory DirectorMegan Miller
Laboratory Phone(740) 348-7915
Laboratory LocationLicking Memorial Family Practice Heath687 Hopewell Dr Building 2, Heath, OH 43056
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 1487688545. It was assigned to this organization in the NPPES registry on July 11, 2006. The provider is doing business as Licking Memorial Family Practice Heath.

Where is Licking Memorial Professional Corp. located?

Licking Memorial Professional Corp. is located at 687 Hopewell Dr Suite2, Heath, OH 43056. The listed phone number is (740) 348-7915.

What is Licking Memorial Professional Corp.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Licking Memorial Professional Corp. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D1036911) is associated with this NPI, valid through March 21, 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 August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.