Nicholas Lacivita

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

30993 Issued in MS

Practice address

613 Marquette Rd
Brandon, MS 39042-3038

Phone

(601) 824-0342

NPI assigned

May 26, 2021

Last updated

Sep 11, 2024By 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 MS, TN2 enrollments

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 2

Specialty

Psychiatry

Education

William Carey University College of Osteopathic Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

River Region Psychiatry Associates, LLCGroup PAC ID 1254491012, 118 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tristar Centennial Medical Center Hospital, Nashville, TN, CCN 440161

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• River Region Psychiatry Associates LLC

  dba Ally Psychiatry

  • Psychiatry Physician
  • Montgomery, AL
  • NPI 1386891497

  TN

  Medicare reassignment Care Compare group NPD
• TBD Acquisition II LLC

  dba Gulfport Behavioral Health System

  • Psychiatric Hospital
  • Gulfport, MS
  • NPI 1750891792
  Medicare reassignment NPD
• TBD Acquisition II LLC

  dba Gulfport Behavioral Health

  • Psychiatry Physician
  • Gulfport, MS
  • NPI 1780191577
  NPD
• TBD Acquisition II, LLC

  dba Gulfport Behavioral Health System

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1003324419
  NPD
• River Region Psychiatry Associates LLC

  dba Ally Psychiatry

  • Psychiatry Physician
  • Franklin, TN
  • NPI 1336949056
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HCA Health Services of Tennessee, Inc.

  dba Tristar Centennial Medical Center

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1023055126
  Care Compare affiliation

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1700451291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 157A",
            "city": "WHITFIELD",
            "state": "MS",
            "postal_code": "391930157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 MARQUETTE RD",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423038",
            "telephone_number": "601-824-0342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Mississippi State Hospital",
            "address_purpose": "LOCATION",
            "city": "Whitfield",
            "state": "MS",
            "postal_code": "391930157",
            "country_code": "US",
            "telephone_number": "601-351-8555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACIVITA",
        "first_name": "NICHOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-26",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MS",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "30993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Sharp Kirk, P-CMHT
• Leslie Kirk
• Kroger Limited Partnership I (Kroger Pharmacy)
• Kroger Limited Partnership I (Kroger Pharmacy)
• Heather Michelle Kuriger, FNP
• Lakeland Home Program, LLC (Fresenius Medical Care Dialysis SVC of Rankin County Brandon)
• Carla A Lambright
• Rosalin Marie Landrews
• Donna Landry
• Kaylen N Landry, LMSW

• Psychiatry Physician in Brandon, MS
• Providers in Brandon, MS by specialty
• Psychiatry Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.