NPIMap

Individual provider Active NPI

Charles Peter Lichty II, M.D.

  • Internal Medicine Physician
  • Birmingham, AL
National Provider Identifier
1487627766
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
00024704 Issued in AL
Practice address
833 Saint Vincents Dr Ste 300
Pob III
Birmingham, AL 35205-1612
Phone
(205) 939-4512
Fax
(205) 939-4519
NPI assigned
Feb 8, 2006
Last updated
Mar 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 00024704 AL Primary

Addresses

Primary practice location

833 Saint Vincents Dr Ste 300
Pob III
Birmingham, AL 35205-1612

Mailing address

833 Saint Vincents Dr Ste 300
Pob III
Birmingham, AL 35205-1612
Phone (205) 939-4512

Other identifiers 2

IdentifierTypeStateIssuer
132874MedicaidAL
1487627766OtherALBCBS AL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address charleslichtymd@southviewm.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040821000164 AL Practitioner - Internal Medicine 3971577412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Emory University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southview Medical Group, PCGroup PAC ID 8729979794, 40 clinicians

Practice addresses (Care Compare)

833 Saint Vincents Dr
Suite 300
Birmingham, AL 35205-1612
Phone (205) 933-4640

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00024704ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southview Medical Group, PC Internal Medicine CurrentSince Nov 28, 2011 Accepting new patients
Carraway Emergency Physicians, LLC Past Accepting new patients
Birmingham Infectious Diseases, PC PastSince Jul 21, 2012 Accepting new patients
BHC - Montclair Hospitalist Internal Medicine PastSince Aug 1, 2001 Accepting new patients
Birmingham Internal Medicine Associates, LLC Internal Medicine Past Accepting new patients
Premier Medical Past Accepting new patients
Uab Southview LLC Internal Medicine Past Accepting new patients

Locations

833 Saint Vincents Dr
Ste 300
Birmingham, AL 35205
Phone (205) 933-4640

833 Saint Vincents Dr
Ste 502
Birmingham, AL 35205
Phone (205) 933-4400

Interoperability endpoints

  • Direct secure messaging: charleslichtymd@southviewm.allscriptsdirect.net
  • FHIR API: https://api.platform.athenahealth.com/16756/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1262

Organizations & group practices 7

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1487627766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 SAINT VINCENTS DR STE 300",
            "address_2": "POB III",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051612",
            "telephone_number": "205-939-4512",
            "fax_number": "205-939-4519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 SAINT VINCENTS DR STE 300",
            "address_2": "POB III",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051612",
            "telephone_number": "205-939-4512",
            "fax_number": "205-939-4519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTY",
        "first_name": "CHARLES",
        "middle_name": "PETER",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00024704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132874",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AL",
            "identifier": "1487627766",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charleslichtymd@southviewm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "833 Saint Vincents Dr Ste 300",
            "address_2": "POB III",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352051612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.