Licking County

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

35-04-2030-M Issued in OH

Legal business name

LICKING COUNTY

Practice address

675 Price Rd NE
Newark, OH 43055-9454

Phone

(740) 349-6535

Fax

(740) 349-6510

NPI assigned

Mar 8, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. R. Joseph Ebel, R.S, M.S, M.B.A

Title

Health Commissioner

Phone

(740) 349-6535

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Licking County Health Department Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Licking County Board of MRDD

  • Case Management Agency
  • Newark, OH
  • NPI 1215795828
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1891763876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 PRICE RD NE",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430559454",
            "telephone_number": "740-349-6535",
            "fax_number": "740-349-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 PRICE RD NE",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430559454",
            "telephone_number": "740-349-6535",
            "fax_number": "740-349-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LICKING COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "EBEL",
        "authorized_official_first_name": "R.",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "HEALTH COMMISSIONER",
        "authorized_official_telephone_number": "740-349-6535",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.S, M.S, M.B.A"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "OH",
            "license": "35-04-2030-M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0291670",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "600001195",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MT.CARMEL HEALTH-MEDIGOLD",
            "identifier": "FV90771",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Licking County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Kay Lewis, RN
• Marc J Lewis, D.D.S.
• Mary Rose Ashbrook Lewis, LSW
• Terrell Lewis
• Alexander Libertini
• Licking County Aging Program, Inc.
• Licking County Alcoholism Prevention Program
• Licking County Alcoholism Prevention Program
• Licking County Board of MRDD
• Licking County Board of MRDD

• Public Health or Welfare Agency in Newark, OH
• Providers in Newark, OH by specialty
• Public Health or Welfare Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.