NPIMap

Individual provider Active NPI

John G Preddy, DO

  • Family Medicine Physician
  • Uvalde, TX
National Provider Identifier
1922064955
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J0786 Issued in TX
Practice address
126 W Nopal St
Uvalde, TX 78801-5210
Phone
(830) 278-7101
Fax
(866) 935-9737
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X J0786 TX
Family Medicine Physician 207Q00000X J0786 TX Primary

Addresses

Primary practice location

126 W Nopal St
Uvalde, TX 78801-5210

Mailing address

126 W Nopal St
Uvalde, TX 78801-5210
Phone (830) 278-7101

Other identifiers 4

IdentifierTypeStateIssuer
063378601MedicaidTX
091813803MedicaidTX
091813801MedicaidTX
091813802MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121017000925 TX Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 5698890192 Reassigns benefits to 1 organization
Practice locations: Uvalde, TX
O20100920001114 TX Part A Provider - Rural Health Clinic 7719002211 Practice locations: Uvalde, TX

Rural health clinic certification: CCN 453818

Legal name
DR. JOHN G PREDDY D O
Doing business as
FAMILY PRACTICE CENTER OF UVALDE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 17, 1991
Last certification
Jun 8, 2022
Ownership / control type
1A
Organization structure
Sole ProprietorProprietary
Enrollment address
126 W Nopal St
John G. Preddy, D.O. RHC
Uvalde, TX 78801-5210

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Lotus Medical Group LLC 6 clinicians

Practice addresses (Care Compare)

126 W Nopal
Uvalde, TX 78801-5210

126 W Nopal St
Uvalde, TX 78801-5210
Phone (830) 278-7101

7600 Chevy Chase Dr
Suite 300
Austin, TX 78752-1599
Phone (817) 910-6711

Hospital & facility affiliations

  • American Medical Home Health Services - San Antonio LLC Home health agency, San Antonio, TX, CCN 457907
  • Home Care Providers of Texas Home health agency, Dallas, TX, CCN 453157
  • Legend Hospice and Palliative Care Hospice, Fort Worth, TX, CCN 671731
  • Uvalde Memorial Hospital Hospital, Uvalde, TX, CCN 451387
  • Dimmit Regional Hospital Hospital, Carrizo Springs, TX, CCN 451390
  • Avir at Camp Wood Nursing home, Camp Wood, TX, CCN 675931
  • Avir at Cotulla Nursing home, Cotulla, TX, CCN 676288
  • Whispering Springs Rehabilitation and Healthcare C Nursing home, Carrizo Springs, TX, CCN 675373
  • Uvalde Healthcare and Rehabilitation Center Nursing home, Uvalde, TX, CCN 675532
  • Amistad Nursing and Rehabilitation Center Nursing home, Uvalde, TX, CCN 455536

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J0786TXMDRural Health Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Lotus Medical Group LLC CurrentSince Nov 1, 2024 Accepting new patients
Frio Hospital District Past Accepting new patients
Uvalde County Hospital Authority Past Accepting new patients
Nexion Health at Carrizo Springs, Inc. Past Accepting new patients
West Wharton County Hospital District Past Accepting new patients
John G Preddy DO Rural Health PastSince Aug 22, 2012 Accepting new patients
Trinity Med Care Past Accepting new patients
West Wharton County Hospital District Past Accepting new patients
County of la Salle Past Accepting new patients

Locations

7881 W Charleston Blvd
Ste 230
Las Vegas, NV 89117
Phone (702) 508-2153

7600 Chevy Chase Dr
Ste 300
Austin, TX 78752
Phone (512) 318-2503

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John G. Preddy Individual 5% Or Greater Direct Ownership Interest Sep 15, 2010
W-2 Managing EmployeeOffice Supervisor Sep 15, 2010 5%

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Avir at CotullaCotulla, TX, CCN 676288 Skilled nursing facility Adp of the SNF Dec 1, 2022
Avir at CampwoodCamp Wood, TX, CCN 675931 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2025
Mar 1, 2025
Devine Health and RehabilitationDevine, TX, CCN 675489 Skilled nursing facility Adp of the SNF Jan 1, 2025

Owned or controlled facilities with NPI records 3

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

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1922064955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 W NOPAL ST",
            "city": "UVALDE",
            "state": "TX",
            "postal_code": "788015210",
            "telephone_number": "830-278-7101",
            "fax_number": "830-278-1465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 W NOPAL ST",
            "city": "UVALDE",
            "state": "TX",
            "postal_code": "788015210",
            "telephone_number": "830-278-7101",
            "fax_number": "866-935-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREDDY",
        "first_name": "JOHN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2021-01-25",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TX",
            "license": "J0786",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J0786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063378601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091813803",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091813801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091813802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Uvalde, TX

Sources for this page

Verify at the official NPI Registry.