Fredericksburg Family Clinic PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FREDERICKSBURG FAMILY CLINIC PA

Doing business as

Cornerstone Clinic

Practice address

514 W Windcrest St
Fredericksburg, TX 78624-4633

Phone

(830) 997-0330

NPI assigned

Nov 13, 2006

Last updated

Nov 18, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. John Foster

Title

Manager

Phone

(830) 992-2720

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Cornerstone Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Fredericksburg Family Clinic PA

  dba Cornerstone Clinic at Comfort

  • Family Medicine Physician
  • Comfort, TX
  • NPI 1053464982

  O20070216000138

  Same enrollment

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

CLIA laboratory certificates

Tax ID family

Cornerstone Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fredericksburg Family Clinic PA

  dba Cornerstone Clinic at Comfort

  • Family Medicine Physician
  • Comfort, TX
  • NPI 1053464982
  NPD tax ID

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Erika Broslat Benfield, FNP-C

  • Family Nurse Practitioner
  • Fredericksburg, TX
  • NPI 1902156524
  NPD
• Karen G Cornett, MD

  • Family Medicine Physician
  • Fredericksburg, TX
  • NPI 1376538223
  NPD
• Matthew J Hoermann, MD

  • Family Medicine Physician
  • Fredericksburg, TX
  • NPI 1790770634
  NPD
• Kelle Pardi, FNP-C

  • Family Nurse Practitioner
  • Boerne, TX
  • NPI 1548535636
  NPD
• Mason Payne, MD

  • Family Medicine Physician
  • Fredericksburg, TX
  • NPI 1417694035
  NPD
• John P Ramsay, MD

  • Family Medicine Physician
  • Fredericksburg, TX
  • NPI 1053306704
  NPD
• Nancy M Rickerhauser, M.D.

  • Family Medicine Physician
  • Comfort, TX
  • NPI 1245225135
  NPD
• Kristi Ann Stafford, MD

  • Family Medicine Physician
  • Fredericksburg, TX
  • NPI 1962497610
  NPD
• Keilah Marie Barton, DO

  • Family Medicine Physician
  • Fort Walton Beach, FL
  • NPI 1659931962
  NPD
• Mark D Eden, MD

  • Family Medicine Physician
  • Fredericksburg, TX
  • NPI 1275528119
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574035200000",
    "number": "1306917141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 W WINDCREST ST",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244633",
            "telephone_number": "830-997-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 W WINDCREST ST",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244633",
            "telephone_number": "830-997-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICKSBURG FAMILY CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2019-11-18",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "830-992-2720",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID EPSDT",
            "identifier": "189877702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DG7779",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189877703",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "0009QH",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cornerstone Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fredericksburg Anesthesia Consultants PLLC
• Fredericksburg Clinic, PLLC
• Fredericksburg Dentistry, PLLC
• Fredericksburg Drug Co
• Fredericksburg Eye Associates, PLLC
• Fredericksburg Isd
• Fredericksburg LTC
• Fredericksburg Nursing and Rehabilitation LP
• Fredericksburg Oral Surgery PLLC (Oral Surgery of Fredericksburg)
• Fredericksburg Physical Therapy Limited Partnership

• Family Medicine Physician in Fredericksburg, TX
• Providers in Fredericksburg, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.