NPIMap

Organization Active NPI

Fortress Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Richardson, TX
National Provider Identifier
1043678501
Registry record updated Jan 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
FORTRESS EMERGENCY PHYSICIANS, PLLC
Practice address
401 W Campbell Rd
Richardson, TX 75080-3416
Phone
(469) 401-2386
NPI assigned
Jan 29, 2016
Last updated
Jan 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2016

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

Authorized official

Name
William C Jernberg, MD
Title
Officer
Phone
(469) 401-2386

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

401 W Campbell Rd
Richardson, TX 75080-3416

Mailing address

PO Box 98962
Las Vegas, NV 89193-8962

National Provider Directory

National Provider Directory
Tax ID family
Fortress Emergency Physicians PPLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454025600000",
    "number": "1043678501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98962",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891938962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W CAMPBELL RD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803416",
            "telephone_number": "469-401-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTRESS EMERGENCY PHYSICIANS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-29",
        "last_updated": "2016-01-29",
        "status": "A",
        "authorized_official_last_name": "JERNBERG, MD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "469-401-2386"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.