NPIMap

Organization Active NPI

Texas Em-1 Medical Services, PA

  • Physician Assistant
  • Mesquite, TX
National Provider Identifier
1295780757
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
TEXAS EM-1 MEDICAL SERVICES, PA
Practice address
3500 I-30
Mesquite, TX 75150
Phone
(972) 698-3300
NPI assigned
May 23, 2006
Last updated
Feb 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Authorized official

Name
Dr. William C Jernberg, MD
Title
President
Phone
(214) 712-2000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X Primary
Emergency Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SE0003X

Addresses

Primary practice location

3500 I-30
Mesquite, TX 75150

Mailing address

1717 Main St
Suite 5200
Dallas, TX 75201-4605
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

Practitioners & affiliated clinicians

Practitioners 67

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.

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202256000000",
    "number": "1295780757",
    "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": "752014605",
            "telephone_number": "214-712-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 I-30",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "75150",
            "telephone_number": "972-698-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS EM-1 MEDICAL SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2008-02-06",
        "status": "A",
        "authorized_official_last_name": "JERNBERG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-712-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "364SE0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Emergency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; 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.