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THOMAS KOTHEIMER PA
NPI 1235126053
Physician Assistant - Medical in Orange Park, FL

Active since October 06, 2005
2161 KINGSLEY AVE, STE 200, ORANGE PARK, FL 32073(904) 727-3139(904) 276-7434 Get Directions Write a Review

NPPES record last updated: May 24, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Thomas Kotheimer Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THOMAS KOTHEIMER PA (NPI 1235126053) is an individual medical provider in Orange Park, Florida, licensed in Florida (PA 2559) and active in the NPI registry since October 2005.

NPPES Registry Identity

NPI1235126053
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameTHOMAS KOTHEIMERCredential: PA
Location Address2161 KINGSLEY AVE, STE 200Orange Park, FL 32073-5113
Mailing Address9143 Philips Hwy, Ste 560Jacksonville, FL 32256-1348 · (904) 363-2113 · Fax (904) 363-7453
Phone(904) 727-3139
Fax(904) 276-7434
Sole ProprietorNo
Enumeration DateOctober 6, 2005
Last NPPES UpdateMay 24, 2012
✔ NPI 1235126053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in FL · PA 2559
2161 KINGSLEY AVE, Orange Park, FL 32073
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Other Identifiers 6

Medicaid291828500FL
Medicare PINP00762566FL
Medicare PINE3594WFL
OtherY03PUFL · Bcbsfl
Medicare PINE3594VFL
Medicare UPINS98518FL

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KELLEY A TRENT MD
Internal Medicine (Hematology & Oncology)
2161 KINGSLEY AVE, STE 200
ORANGE PARK, FL 32073
Clay County (904) 272-3139
DWELVIN L SIMMONS MD
Radiology (Radiation Oncology)
2161 KINGSLEY AVE, SUITE 100
ORANGE PARK, FL 32073
Clay County (904) 276-2303
SHYAM BHOJRAJ PARYANI MD
Radiology (Radiation Oncology)
2161 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 276-2303
INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC
Radiology (Radiation Oncology)
2161 KINGSLEY AVE, SUITE 100
ORANGE PARK, FL 32073
Clay County (904) 276-2303

Frequently 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 Thomas Kotheimer's NPI number?

The NPI number for Thomas Kotheimer is 1235126053. It was assigned to this individual provider in the NPPES registry on October 6, 2005.

Where is Thomas Kotheimer located?

Thomas Kotheimer practices at 2161 Kingsley Ave Ste 200, Orange Park, FL 32073. The listed phone number is (904) 727-3139.

What is Thomas Kotheimer's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Thomas Kotheimer was last updated on May 24, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.