Redditt Emergency Physicians

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

REDDITT EMERGENCY PHYSICIANS

Practice address

505 S John Redditt Dr
Lufkin, TX 75904-3120

Phone

(936) 637-8567

NPI assigned

May 22, 2006

Organization subpart

No

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) 712-2074

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1295789212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191013100",
            "telephone_number": "800-355-0808",
            "fax_number": "214-712-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S JOHN REDDITT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043120",
            "telephone_number": "936-637-8567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDDITT EMERGENCY PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2008-04-20",
        "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": "214-712-2074",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0013JQ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.