NPIMap

Individual provider Active NPI

Christine Roddy Lichtenberg, FNP-C

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1518645407
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0998808-NP Issued in CO
Practice address
7675 Mission Valley Rd
San Diego, CA 92108-4429
Phone
(970) 397-6614
NPI assigned
Jul 10, 2023
Last updated
Jul 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0998808-NP CO Primary

Addresses

Primary practice location

7675 Mission Valley Rd
San Diego, CA 92108-4429

Mailing address

7675 Mission Valley Rd
San Diego, CA 92108-4429
Phone (970) 397-6614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20231106001391 CO Practitioner - Nurse Practitioner 4587011010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 S Cherry Ave
Unit 1
Eaton, CO 80615-8256
Phone (970) 454-3838

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians Colorado LLC CurrentSince Mar 9, 2025 Accepting new patients
Banner Health Physicians Colorado LLC Past Accepting new patients

Locations

100 S Cherry Ave
Unit 1
Eaton, CO 80615
Phone (970) 454-1265

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

2001 70th Ave
Ste 300
Greeley, CO 80634
Phone (970) 527-1122

5623 19th St
Greeley, CO 80634
Phone (970) 353-9011

Organizations & group practices 2

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 12

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": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1518645407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7675 MISSION VALLEY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084429",
            "telephone_number": "970-397-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7675 MISSION VALLEY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084429",
            "telephone_number": "970-397-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTENBERG",
        "first_name": "CHRISTINE",
        "middle_name": "RODDY",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0998808-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.