FREDERICKSBURG CLINIC, PLLC
NPI 1033145545
Family Medicine in Fredericksburg, TX
About Fredericksburg Clinic, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FREDERICKSBURG CLINIC, PLLC (NPI 1033145545) is a healthcare organization registered as a family medicine in Fredericksburg, Texas and active in the NPI registry since June 2006. The organization holds an CLIA Accreditation certificate valid through August 22, 2028 and lists John Radcliffe Kothmann, Authorized Official, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 4
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Fredericksburg Clinic, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
13Medicare enrollment records show 13 clinicians reassign Medicare billing to Fredericksburg Clinic, PLLC, which bills Medicare for the services they deliver. Of these, 11 practice within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (13)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
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 Accreditation 45D0504078
Fredericksburg Clinic · Fredericksburg, TXFrequently 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 Fredericksburg Clinic, PLLC's NPI number?
The NPI number for Fredericksburg Clinic, PLLC is 1033145545. It was assigned to this organization in the NPPES registry on June 25, 2006.
Where is Fredericksburg Clinic, PLLC located?
Fredericksburg Clinic, PLLC is located at 1308 South Highway 16, Fredericksburg, TX 78624. The listed phone number is (830) 997-2181.
What is Fredericksburg Clinic, PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Fredericksburg Clinic, PLLC enrolled in Medicare?
Yes. Fredericksburg Clinic, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Fredericksburg Clinic, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 13 clinicians in 3 Medicare specialties reassign their Medicare billing to Fredericksburg Clinic, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (5), Internal Medicine (5) and Nurse Practitioner (3). Of these, 11 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Fredericksburg Clinic, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Accreditation (number 45D0504078) is associated with this NPI, valid through August 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Fredericksburg Clinic, PLLC was last updated on November 20, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.
# Fredericksburg Clinic, Pllc · NPI 1033145545
Family Medicine organization in Fredericksburg, Texas. Organization record, active in the CMS NPPES registry since June 25, 2006.
## Identity
- **NPI:** 1033145545 (Entity type: Organization)
- **Enumerated:** June 25, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** John Kothmann, AUTHORIZED OFFICIAL
## Practice location
- **Address:** 1308 SOUTH HIGHWAY 16, Fredericksburg, TX 78624-5058
- **Phone:** (830) 997-2181 · **Fax:** (830) 997-9598
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 13 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (5), Internal Medicine (5), Nurse Practitioner (3); 11 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 20, 2017
- **Other identifiers:** Medicaid 082891502 (TX); Medicare PIN 00NB71 (TX); Medicaid 084372401 (TX); and 1 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1033145545) · Data from the CMS NPPES public registry.