Organization Active NPI

Texas Em-1 Medical Services, P.a.

  • Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1255638854
Registry record updated Feb 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
TEXAS EM-1 MEDICAL SERVICES, P.A.
Practice address
11380 Gateway Blvd N
El Paso, TX 79934-3380
Phone
(915) 757-4000
NPI assigned
Feb 16, 2011
Last updated
Feb 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2011

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

Authorized official

Name
William C Jernberg, M.D.
Title
Owner
Phone
(214) 712-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

11380 Gateway Blvd N
El Paso, TX 79934-3380

Mailing address

1717 Main St
Suite 5200
Dallas, TX 75201-4612
Phone (214) 712-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000296 TX Part B Supplier - Clinic/Group Practice 6507760543 Receives reassigned benefits from 96 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: League City, TX; Webster, TX; McKinney, TX; Galveston, TX; Angleton, TX

National Provider Directory

National Provider Directory

Locations

11380 Gateway Blvd N
El Paso, TX 79934
Phone (915) 747-4000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297814400000",
    "number": "1255638854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 MAIN ST",
            "address_2": "SUITE 5200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752014612",
            "telephone_number": "214-712-2000",
            "fax_number": "214-712-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11380 GATEWAY BLVD N",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799343380",
            "telephone_number": "915-757-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS EM-1 MEDICAL SERVICES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-16",
        "last_updated": "2011-02-16",
        "status": "A",
        "authorized_official_last_name": "JERNBERG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-712-2000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.