NC Immunology, PC

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

Legal business name

NC IMMUNOLOGY, PC

Practice address

1414 Fern Creek Dr
Statesville, NC 28625-9376

Phone

(704) 873-5055

Fax

(704) 873-5025

NPI assigned

Dec 19, 2024

Organization subpart

No

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

Authorized official

Name

Anna M Jackson

Title

Office Administrator

Phone

(704) 873-5055

Specialties & licenses 4

Addresses

Other names 2

• NC IMMUNOLOGY, PC Doing business as
• NC Immunology Allergy and Asthma Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Frank John Lichtenberger, MD, PHD

  • Allergy & Immunology Physician
  • Statesville, NC
  • NPI 1750590097
  Medicare reassignment Care Compare group NPD
• Ednah Kwamboka Oyaro, FNP

  • Family Nurse Practitioner
  • Statesville, NC
  • NPI 1932675345
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1734566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781049600000",
    "number": "1619785920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 FERN CREEK DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286259376",
            "telephone_number": "704-873-5055",
            "fax_number": "704-873-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 FERN CREEK DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286259376",
            "telephone_number": "704-873-5055",
            "fax_number": "704-873-5025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Fairview Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281179507",
            "country_code": "US",
            "telephone_number": "704-873-5055",
            "fax_number": "704-873-5025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NC IMMUNOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-19",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "704-873-5055"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NC IMMUNOLOGY, PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NC Immunology Allergy and Asthma",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hilana Nashad, M.D.
• Angelia Smith Natili, MD
• National Vision, Inc.
• Natural Beginnings Birth and Wellness Center
• Natural Beginnings Birth Center
• Donald Jeffrey Neal, D.O.
• Kim Kerry Neely, PAC
• Robert Bruce Neill III, CRNA
• Sherry Neilson, RN
• Melissa Walker Nelson

• Allergy & Immunology Physician in Statesville, NC
• Providers in Statesville, NC by specialty
• Allergy & Immunology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.