John Paschal Licata, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2020-00623 Issued in NC

Practice address

1800 Al Highway 157
Cullman, AL 35058-1271

Phone

(256) 735-5075

Fax

(256) 964-3382

NPI assigned

Mar 27, 2017

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

Other identifiers 1

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jlicata136898@carolinashealthcaresystem.direct-ci.com
• Direct secure messaging: drlicata@westalabamapediatrics.opdirect.net

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.

• Carolinas Physicians Network Inc

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1437607686
  Medicare reassignment NPD
• Carolinas Physicians Network Inc

  • Obstetrics & Gynecology Physician
  • Concord, NC
  • NPI 1023291960
  NPD
• Carolinas Physicians Network Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD
• CRMC Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Cullman, AL
  • NPI 1467083675
  NPD (past)
• Carolinas Physicians Network Inc

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1740848100
  NPD (past)

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1740711076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2895",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350562895",
            "telephone_number": "256-735-5044",
            "fax_number": "256-801-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 AL HIGHWAY 157",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350581271",
            "telephone_number": "256-735-5075",
            "fax_number": "256-964-3382"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13640 Steelecroft Pkwy",
            "address_2": "Ste 210",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282787565",
            "country_code": "US",
            "telephone_number": "704-512-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4501 Cameron Valley Pkwy",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114297",
            "country_code": "US",
            "telephone_number": "704-367-7400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "332 N Trade St",
            "address_2": "Ste 1500",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281051728",
            "country_code": "US",
            "telephone_number": "704-512-6820",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1656 Riverchase Blvd",
            "address_2": "Ste 3400",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297322084",
            "country_code": "US",
            "telephone_number": "803-328-6281",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6235 Blakeney Park Dr",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282775658",
            "country_code": "US",
            "telephone_number": "704-512-5060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICATA",
        "first_name": "JOHN",
        "middle_name": "PASCHAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-27",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2020-00623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD47191",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlicata136898@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "13640 Steelecroft Pkwy",
            "address_2": "Ste 210",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282787565",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Meredith Alicia Lee, NP-C
• Samantha Legg, CRNP
• Leigha Weaver Lentini, CRNP
• Anna Lewis, PH.D.,D.C.
• Nathaniel Benson Lewis, D.C.
• Life Care Hospice
• Alexis Lindsey
• Emily Lindsey, MA
• Kristy Lindsey
• Katherine Kirkpatrick List, LICSW

• Pediatrics Physician in Cullman, AL
• Providers in Cullman, AL by specialty
• Pediatrics Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.