Individual provider Active NPI

Frank John Lichtenberger, MD, PHD

  • Allergy & Immunology Physician
  • Statesville, NC
National Provider Identifier
1750590097
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
2012-00072 Issued in NC
Practice address
1414 Fern Creek Dr
Statesville, NC 28625-9376
Phone
(704) 873-5055
Fax
(704) 873-5025
NPI assigned
May 22, 2007
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X 201200072 NC
Allergy & Immunology Physician 207K00000X 2012-00072 NC Primary
Gastroenterology Physician 207RG0100X 2012-00072 NC
Rheumatology Physician 207RR0500X 2012-00072 NC

Addresses

Primary practice location

1414 Fern Creek Dr
Statesville, NC 28625-9376

Mailing address

1414 Fern Creek Dr
Statesville, NC 28625-9376
Phone (704) 873-5055

Other practice location 1

150 Fairview Rd Ste 210
Mooresville, NC 28117-9507
Phone (704) 873-5055 ext. 35055

Other identifiers 5

IdentifierTypeStateIssuer
BP1-0026150OtherINSTITUTIONAL PERMIT
NC5595A950OtherNCMEDICARE PTAN
1750590097MedicaidNC
4186144100MedicaidMD
NC2529MedicaidSC

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120430000208 NC Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 1850430406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Ohio State University College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NC Immunology PCGroup PAC ID 3274055009, 2 clinicians

Practice addresses (Care Compare)

150 Fairview Rd
Suite 210
Mooresville, NC 28117-9507
Phone (704) 873-5055

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012-00072NCMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NC Immunology, PC Allergy & Immunology CurrentSince Feb 10, 2025 Accepting new patients
Columbus Regional Health Network Past Accepting new patients
Frederick Health Hospital Inc Infusion Therapy Past Accepting new patients

Locations

150 Fairview Rd
Ste 210
Mooresville, NC 28117
Phone (704) 235-0300

1414 Fern Creek Dr
Statesville, NC 28625
Phone (704) 660-4968

1525 Davie Ave
Statesville, NC 28677
Phone (704) 873-5055

Interoperability endpoints

  • Direct secure messaging: lichtenberger.frank.322.0330293@nci.meditab.direct-ci.com
  • Direct secure messaging: lichtenberger.frank.326.0330293@nci.meditab.direct-ci.com

Organizations & group practices 3

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 1

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1750590097",
    "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 x35055",
            "fax_number": "704-873-5025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICHTENBERGER",
        "first_name": "FRANK",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "NC",
            "license": "201200072",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NC",
            "license": "2012-00072",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "2012-00072",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NC",
            "license": "2012-00072",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP1-0026150",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NC5595A950",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750590097",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4186144100",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2529",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.