Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1740711076 Individual Practitioner Male Practitioner

Dr. John Paschal Licata , MD

Pediatrics • Cullman, AL

Professional Overview & Biography Verified Profile Summary

Dr. John Licata, MD is a registered healthcare professional specializing in Pediatrics in Cullman, AL. Practice services are available at 1800 AL HIGHWAY 157 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1800 Al Highway 157

Cullman, AL 350581271

Telephone 2567355075
Fax 2569643382
Associated Practice Facility / Clinic
🏢 Crmc Medical Group Llc Facility NPI 1467083675

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Cullman, AL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 28.7 Yrs
Regional Practice Density
11 Specialists

Practicing in Cullman, AL (853 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-02-11
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License NC 2020-00623

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Medical License
MD47191 (AL)

Secondary Practice Locations

1656 Riverchase Blvd, Ste 3400

Rock Hill, SC 297322084

Phone: 8033286281

4501 Cameron Valley Pkwy, Ste 100

Charlotte, NC 282114297

Phone: 7043677400

332 N Trade St, Ste 1500

Matthews, NC 281051728

Phone: 7045126820

6235 Blakeney Park Dr, Ste 100

Charlotte, NC 282775658

Phone: 7045125060

13640 Steelecroft Pkwy, Ste 210

Charlotte, NC 282787565

Phone: 7045126100

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

13 Associated Practitioners
NPI 1114542396

Doctor of Osteopathic Medicine (D.O.)

Kara Moore , CRNP

Nurse Practitioner - Neonatal, Critical Care

NPI 1407113608

Certified Registered Nurse Practitioner

Bethany Lamar , CRNP

Nurse Practitioner - Family

NPI 1467494914

Certified Registered Nurse Practitioner

Dr. John Morgan , MD

Family Medicine

NPI 1487767224

Doctor of Medicine (M.D.)

NPI 1497999742

Doctor of Medicine (M.D.)

NPI 1548422868

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

15 Historical Events
📍
Updated Practice Location May 14, 2025

Registered at 1800 AL HIGHWAY 157, CULLMAN, AL 350581271 (Tel: 2567355075)

📍
Updated Business Mailing Address May 14, 2025

Registered at PO BOX 2895, CULLMAN, AL 350562895 (Tel: 2567355075)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 06, 2022

Pediatrics (License #2020-00623 in NC)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 10, 2021

Pediatrics (License #83406 in SC)

📍
Updated Practice Location August 31, 2020

Registered at 13640 STEELECROFT PKWY, STE 210, CHARLOTTE, NC 282787565 (Tel: 7045126100)

📍
Updated Business Mailing Address August 31, 2020

Registered at PO BOX 19305, CHARLOTTE, NC 282199305

📍
Updated Practice Location July 01, 2020

Registered at 13640 STEELECROFT PKWY STE 210, CHARLOTTE, NC 282787878 (Tel: 7045126100)

📍
Updated Business Mailing Address July 01, 2020

Registered at 13640 STEELECROFT PKWY STE 210, CHARLOTTE, NC 282787878 (Tel: 7045126100)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 01, 2020

Pediatrics (License #2020-00623 in NC)

NPI Profile Active March 27, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location March 27, 2017

Registered at 1000 BLYTHE BLVD FL 4, CHARLOTTE, NC 282035812 (Tel: 7043816800)

📍
Updated Business Mailing Address March 27, 2017

Registered at 1000 BLYTHE BLVD FL 4, CHARLOTTE, NC 282035812 (Tel: 7043816800)

👤
Provider Name / Credentials Updated March 27, 2017

Recorded as JOHN LICATA, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 27, 2017

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 27, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1740711076
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 27, 2017
Last Update: February 11, 2026
Sole Proprietor: No

Mailing Address

Po Box 2895

Cullman, AL 350562895

Phone: 2567355044

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.