1. Home
  2. Directory
  3. North Carolina
  4. Statesville
  5. Allergy Immunology
  6. NPI Profile

NC IMMUNOLOGY, PC
NPI 1619785920
Allergy & Immunology in Statesville, NC

Active since December 19, 2024CLIA Certified · 4 labs
1414 FERN CREEK DR, STATESVILLE, NC 28625(704) 873-5055(704) 873-5025 Get Directions Write a Review

NPPES record last updated: June 10, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 8, 2026, Mar 8, 2026, Dec 24, 2024 and 1 more (4 updates tracked since 2024).

About Nc Immunology, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NC IMMUNOLOGY, PC (NPI 1619785920) is a healthcare organization registered as an allergy & immunology in Statesville, North Carolina and active in the NPI registry since December 2024. The organization holds 4 active CLIA laboratory certificates, maintains a secondary practice location in Mooresville, and lists Anna M Jackson, Office Administrator, as its authorized official.

NPPES Registry Identity

NPI1619785920
Entity TypeOrganization
Primary Taxonomy207K00000X
Legal Business NameNC IMMUNOLOGY, PC
Location Address1414 FERN CREEK DRStatesville, NC 28625-9376
Mailing Address1414 Fern Creek DrStatesville, NC 28625-9376 · (704) 873-5055 · Fax (704) 873-5025
Phone(704) 873-5055
Fax(704) 873-5025
Organization SubpartNo
Authorized OfficialAnna M JacksonOffice Administrator · (704) 873-5055
Enumeration DateDecember 19, 2024
Last NPPES UpdateJune 10, 20264 updates tracked since enumeration
NPPES CertifiedJune 10, 2026
✔ NPI 1619785920 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyAllergy & ImmunologyAllopathic & Osteopathic Physicians
Taxonomy Code207K00000X
Definition
An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system.
Also ListedInternal Medicine · GastroenterologyTaxonomy 207RG0100X
Also ListedInternal Medicine · RheumatologyTaxonomy 207RR0500X
Also ListedClinic/Center · Infusion TherapyTaxonomy 261QI0500X
1414 FERN CREEK DR, Statesville, NC 28625
Open in Google Maps ↗

Other Names 2

Doing Business AsNc Immunology, Pc
Doing Business AsNc Immunology Allergy And Asthma

Secondary Practice Location 1

Location 1150 Fairview Rd Ste 210Mooresville, NC 28117-9507 · Phone (704) 873-5055 · Fax (704) 873-5025

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2327089

Nc Immunology PC · Statesville, NC
Active · expires Jul 15, 2027
CLIA Number34D2327089
Laboratory TypePhysician Office
Certificate Effective DateJuly 16, 2025
Certificate Expiration DateJuly 15, 2027
Laboratory DirectorFrank Lichtenberger
Laboratory Phone(704) 873-5055
Laboratory LocationNc Immunology PC1414 Fern Creek Dr, Statesville, NC 28625
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 34D2322559

Nc Immunology, PC · Mooresville, NC
Active · expires Apr 22, 2027
CLIA Number34D2322559
Laboratory TypePhysician Office
Certificate Effective DateApril 23, 2025
Certificate Expiration DateApril 22, 2027
Laboratory DirectorFrank Lichtenberger
Laboratory Phone(704) 873-5055
Laboratory LocationNc Immunology, PC150 Fairview Road, Suite 210, Mooresville, NC 28117
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 34D2321154

Nc Immunology, PC · Statesville, NC
Active · expires Mar 30, 2027
CLIA Number34D2321154
Laboratory TypePhysician Office
Certificate Effective DateMarch 31, 2025
Certificate Expiration DateMarch 30, 2027
Laboratory DirectorFranl Lichtenberger
Laboratory Phone(704) 873-5055
Laboratory LocationNc Immunology, PC1525 Davie Avenue, Statesville, NC 28677
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 34D2054991

Nc Immunology, PC · Statesville, NC
Active · expires Mar 3, 2027
CLIA Number34D2054991
Laboratory TypePhysician Office
Certificate Effective DateMarch 4, 2025
Certificate Expiration DateMarch 3, 2027
Laboratory DirectorAnna Maria Jackson
Laboratory Phone(704) 873-5055
Laboratory LocationNc Immunology, PC1525 Davie Avenue, Statesville, NC 28677
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DALE KANTRICE RADER MD
Orthopaedic Surgery (Sports Medicine)
1414 FERN CREEK DR
STATESVILLE, NC 28625
Iredell County (704) 873-6065
DR. TIMOTHY ADAM LEONE DO
Surgery
1414 FERN CREEK DR
STATESVILLE, NC 28625
Iredell County (704) 660-4968
MRS. DIANE ALICIA EZERNACK P.T.
Physical Therapist
1414 FERN CREEK DR
STATESVILLE, NC 28625
Iredell County (828) 459-6824
CHELSEA MARIE DUKE PA
Physician Assistant
1414 FERN CREEK DR
STATESVILLE, NC 28625
Iredell County (704) 380-4716
MICHAEL DENNIS GETTER MD
Orthopaedic Surgery
1414 FERN CREEK DR
STATESVILLE, NC 28625
Iredell County (704) 873-6065
DR. FRANK JOHN LICHTENBERGER MD, PHD
Allergy & Immunology
1414 FERN CREEK DR
STATESVILLE, NC 28625
Iredell County (704) 873-5055
STATESVILLE HMA MEDICAL GROUP, LLC
Family Medicine
1414 FERN CREEK DR
STATESVILLE, NC 28625
Iredell County (704) 873-7012
STATESVILLE HMA MEDICAL GROUP, LLC
Family Medicine
1414 FERN CREEK DR
STATESVILLE, NC 28625
Iredell County (704) 978-2250

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nc Immunology, PC's NPI number?

The NPI number for Nc Immunology, PC is 1619785920. It was assigned to this organization in the NPPES registry on December 19, 2024. The provider is doing business as NC Immunology Allergy and Asthma.

Where is Nc Immunology, PC located?

Nc Immunology, PC is located at 1414 Fern Creek Dr, Statesville, NC 28625. The listed phone number is (704) 873-5055.

What is Nc Immunology, PC's specialty?

The primary specialty registered for this NPI is Allergy & Immunology with taxonomy code 207K00000X.

Does Nc Immunology, PC hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Nc Immunology, PC accept?

Health plans from Blue Cross and Blue Shield of NC list Nc Immunology, PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nc Immunology, PC was last updated on June 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.