NPIMap

Individual provider Active NPI

John Radcliffe Kothmann, M.D.

  • Family Medicine Physician
  • Fredericksburg, TX
National Provider Identifier
1780624502
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L8578 Issued in TX
Practice address
1308 South Highway 16
Fredericksburg, TX 78624-5058
Phone
(830) 997-2181
Fax
(830) 997-9598
NPI assigned
Jun 8, 2006
Last updated
Apr 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L8578 TX Primary

Addresses

Primary practice location

1308 South Highway 16
Fredericksburg, TX 78624-5058

Mailing address

1308 South Highway 16
Fredericksburg, TX 78624-5058
Phone (830) 997-2181

Other identifiers 1

IdentifierTypeStateIssuer
166270201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040812000650 TX Practitioner - Family Practice 4385616903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at Houston, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fredericksburg Clinic PLLCGroup PAC ID 3375515992, 10 clinicians

Practice addresses (Care Compare)

1308 S Hwy 16
Fredericksburg, TX 78624-5058
Phone 8309972181290

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fredericksburg Clinic, PLLC Family Medicine CurrentSince Aug 1, 2004 Accepting new patients
Knopp Nursing & Rehabilitation Center Inc Past Accepting new patients
Val Verde County Hospital District Past Accepting new patients

Locations

1308 S State Highway 16
Fredericksburg, TX 78624
Phone (830) 997-2181

Interoperability endpoints

  • Direct secure messaging: john.kothmann@854391770316804.direct.elationemr.com

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Knopp Nursing & Rehabilitation Center IncFredericksburg, TX, CCN 675740 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 27, 2022
Apr 27, 2022
Knopp Healthcare & Rehab Center IncFredericksburg, TX, CCN 455278 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 27, 2022
Apr 27, 2022
Avir at FredericksburgFredericksburg, TX, CCN 675169 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2025
Apr 16, 2025
Votive Hospice LLCFredericksburg, TX, CCN 741764 Hospice Contracted Managing Employee Mar 4, 2020

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 11

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1780624502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 SOUTH HIGHWAY 16",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786245058",
            "telephone_number": "830-997-2181",
            "fax_number": "830-997-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 SOUTH HIGHWAY 16",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786245058",
            "telephone_number": "830-997-2181",
            "fax_number": "830-997-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTHMANN",
        "first_name": "JOHN",
        "middle_name": "RADCLIFFE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L8578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166270201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, TX

Sources for this page

Verify at the official NPI Registry.