| Darren Burgin, CNP | |
| 
					200 Messimer Drive, Newark, OH 43055  | |
| (220) 564-4870 | |
| (220) 564-4871 | 
| Full Name | Darren Burgin | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Practitioner - Psychiatric/mental Health | 
| Location | 200 Messimer Drive, Newark, Ohio | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1629239322 | NPI | - | NPPES | 
| 0088653 | Medicaid | OH | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 163W00000X | Registered Nurse | RN300112 (Ohio) | Secondary | 
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | COA14664NP (Ohio) | Primary | 
| Entity Name | Licking Memorial Professional Corporation | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1326072265 PECOS PAC ID: 6204740731 Enrollment ID: O20031203000131  | 
| Entity Name | Autumn Treatment Center Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1225601826 PECOS PAC ID: 6002204344 Enrollment ID: O20211019002513  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Darren Burgin, CNP 200 Messimer Drive, Newark, OH 43055 Ph: (220) 564-4870  | Darren Burgin, CNP 200 Messimer Drive, Newark, OH 43055 Ph: (220) 564-4870  | 
Joan Crumrine, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: Licking Memorial Family Practice East, 399 E. Main St, Newark, OH 43055 Phone: 220-564-1846 Fax: 220-564-1847  | |
Anna Ruhl, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1320 W Main St, Newark, OH 43055 Phone: 220-564-4151 Fax: 220-564-7153  | |
Mrs. Sarah Elizabeth Karling, APRN, WHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 15 Messimer Dr, Newark, OH 43055 Phone: 220-564-4677  | |
Andrea Sims, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1320 W Main St, Newark, OH 43055 Phone: 220-564-4000  | |
Diane Elaine Kintner, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 675 Price Rd Ne, Newark, OH 43055 Phone: 740-349-6535 Fax: 740-349-6510  | |
Ms. Amanda K Miller, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 68 W Church St Ste 203, Newark, OH 43055 Phone: 740-934-6474 Fax: 740-934-6473  | |
Catherine R Wohlford, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 399 E Main St, Newark, OH 43055 Phone: 220-564-1840 Fax: 220-564-1841  |