NPIMap

Individual provider Active NPI

Karl Kietzke, M.D.

  • Family Medicine Physician
  • Rockport, TX
National Provider Identifier
1104806975
Registry record updated Nov 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L3361 Issued in TX
Practice address
1325 Broadway St
Rockport, TX 78382-3333
Phone
(361) 729-0646
Fax
(361) 729-8854
NPI assigned
Jan 18, 2006
Last updated
Nov 24, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X L3361 TX
Family Medicine Physician 207Q00000X L3361 TX Primary

Addresses

Primary practice location

1325 Broadway St
Rockport, TX 78382-3333

Mailing address

1325 Broadway St
Rockport, TX 78382-3333
Phone (361) 729-0646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eastland Memorial Hospital District Past Accepting new patients
David G. Shulman, M.D., P.a. Past Accepting new patients
Texas Emergency Room Services, PA Emergency Medicine Past Accepting new patients
Socrates Emergency Physicians Emergency Medicine Past Accepting new patients
Victoria Emergency Associates LLC Emergency Medicine Past Accepting new patients
Emergency Pediatric Physician MGMT LLC Past Accepting new patients
Step Emergency Physicians Emergency Medicine Past Accepting new patients
Hondo Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Texas Emergency Room Services, PA Emergency Medicine Past Accepting new patients
Eastland Memorial Hospital District Past Accepting new patients
Cannon Emergency Physicians Emergency Medicine Past Accepting new patients
Hardy Oak Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
South Texas Hospitalist Associates LLC Past Accepting new patients
Leatherland Emergency Physicians PLLC Emergency Medicine Past Accepting new patients

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195862400000",
    "number": "1104806975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 BROADWAY ST",
            "city": "ROCKPORT",
            "state": "TX",
            "postal_code": "783823333",
            "telephone_number": "361-729-0646",
            "fax_number": "361-729-8854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 BROADWAY ST",
            "city": "ROCKPORT",
            "state": "TX",
            "postal_code": "783823333",
            "telephone_number": "361-729-0646",
            "fax_number": "361-729-8854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIETZKE",
        "first_name": "KARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2007-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L3361",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L3361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockport, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.