Robert M. Licata, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2014-01510 Issued in NC

Practice address

120 Coastal Horizons Dr
Shallotte, NC 28470-6094

Phone

(910) 754-4515

NPI assigned

Jan 11, 2007

Last updated

Aug 12, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Georgetown University School of Medicine, 1971

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Coastal Horizons Center, Inc.Group PAC ID 9739267964, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Coastal Horizons Center, Inc.

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1922022607
  Medicare reassignment Care Compare group NPD
• Coastal Horizons Center Inc

  • Community/Behavioral Health Agency
  • Rocky Point, NC
  • NPI 1063082592
  NPD
• Coastal Horizons Center, Inc

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1033420153
  NPD
• Coastal Horizons Center, Inc.

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1790985448
  NPD

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1669522769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 COTTAGE CREEK RD",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284612983",
            "telephone_number": "571-216-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 COASTAL HORIZONS DR",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284706094",
            "telephone_number": "910-754-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICATA",
        "first_name": "ROBERT",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101027066",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2014-01510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Lee, PT
• Amber Nicole Legrande, PT
• Lauren Lengers
• Siena Leone
• Michael Matthew Librie, LCSW-C
• Life Changers Intervention Services LLC
• Lincare Inc.
• Sarah-Ann Livingston
• Kelleyanne Helene Lonergan
• Corey Elizabeth Burr Long, OD

• Psychiatry Physician in Shallotte, NC
• Providers in Shallotte, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.