Rustin Gerhard Licht

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD-42568 Issued in IA

Practice address

200 Hawkins Dr
Iowa City, IA 52242-1009

Phone

(319) 356-1616

NPI assigned

Mar 28, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 29, 2021 through Sep 29, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Meadowlark Partners LLC

  • Clinical Social Worker
  • North Liberty, IA
  • NPI 1023141330
  NPD (past)
• Psychiatric Associates of Iowa, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • North Liberty, IA
  • NPI 1568121457
  NPD (past)
• Psychiatric Associates of Iowa, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • North Liberty, IA
  • NPI 1720709074
  NPD (past)

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

{
    "created_epoch": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1619210549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHT",
        "first_name": "RUSTIN",
        "middle_name": "GERHARD",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-28",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "MD-42568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shihong Li
• Zhenbo Li, PA
• I-Chau Liang, RPH
• Letitia P. Libman, M.S.,PHD.
• Claire Elizabeth Dickey Licht, LMHC
• Tonya Lick
• Susan Lynn Liddiard, D.O.
• Scott Lieberman, M.D., PH.D.
• Connor James Lieser
• Jill L Liesveld, MD

• Psychiatry Physician in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Psychiatry Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.