LICKING MEMORIAL DERMATOLOGY
NPI 1295775435
Dermatology in Newark, OH

NPI Status: Active since June 07, 2006

Contact Information

36 MCMILLEN DR
NEWARK, OH
ZIP 43055
Phone: (740) 348-1755
Fax: (740) 348-1756

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  • Organization
  • Dermatology

About LICKING MEMORIAL DERMATOLOGY

This page provides the complete NPI Profile along with additional information for Licking Memorial Dermatology, a provider established in Newark, Ohio operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1295775435 assigned on June 2006. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Licking Memorial Dermatology. The authorized official of this NPI record is Robert A. Montagnese (Executive Ice President)

NPI
1295775435
Provider Legal Name
LICKING MEMORIAL PROFESSIONAL CORPORATION
Other Organization Name
LICKING MEMORIAL DERMATOLOGY
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
36 MCMILLEN DR NEWARK, OH 43055
Location Phone
(740) 348-1755
Location Fax
(740) 348-1756
Mailing Address
36 MCMILLEN DR NEWARK, OH 43055
Mailing Phone
(740) 348-1755
Mailing Fax
(740) 348-1756
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-07-2006
Last Update Date
08-22-2020
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A dermatologist like Licking Memorial Dermatology is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.

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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

Dermatology

Taxonomy Code
207N00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ROBERT A. MONTAGNESE

Authorized Official Title
EXECUTIVE ICE PRESIDENT
Authorized Official Phone
(740) 348-4000

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
2527975MEDICAID (05)OH 

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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.
1295775435
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
221851471046
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 8 + 5 + 1 + 4 + 7 + 1 + 0 + 4 + 6 + 24 = 65
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 65 = 55

The NPI number 1295775435 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1386152346 LYNNE DUVALL
Individual
Audiologist36 MCMILLEN DR
NEWARK, OH 43055
(740) 344-1304
1033405139DR. BRADLEY R LAWSON M.D.
Individual
Otolaryngology36 MCMILLEN DR
NEWARK, OH 43055
(220) 564-4270
1841256765DR. KENNETH CARROLL PARKER M.D.
Individual
Otolaryngology (Facial Plastic Surgery)36 MCMILLEN DR
NEWARK, OH 43055
(220) 564-4270
1598701286 CHERYL B BARKER
Individual
Audiologist36 MCMILLEN DR
NEWARK, OH 43055
(740) 344-1304

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1295775435, enumerated in the NPI registry as an "organization" on June 07, 2006

The provider is located at 36 Mcmillen Dr Newark, Oh 43055 and the phone number is (740) 348-1755

This medical organization specializes in Dermatology with taxonomy code 207N00000X

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on June 07, 2006. 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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