Lake Jackson Emergency Medical Services, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

020014 Issued in TX

Legal business name

LAKE JACKSON EMERGENCY MEDICAL SERVICES, INC.

Practice address

10 Oak Drive Suite B
Lake Jackson, TX 77566

Phone

(979) 415-2714

Fax

(979) 285-0252

NPI assigned

Jun 6, 2006

Organization subpart

No

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

Authorized official

Name

Christopher Sermarini, NRP

Title

Chief/Executive Director

Phone

(979) 415-2714

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626912000000",
    "number": "1316986201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 OAK DRIVE SUITE B",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "77566",
            "telephone_number": "979-415-2714",
            "fax_number": "979-285-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 OAK DRIVE SUITE B",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "77566",
            "telephone_number": "979-415-2714",
            "fax_number": "979-285-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE JACKSON EMERGENCY MEDICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A",
        "authorized_official_last_name": "SERMARINI",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CHIEF/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "979-415-2714",
        "authorized_official_credential": "NRP"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "TX",
            "license": "20014",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "020014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000731201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake Jackson Audiology and Hearing Aid Consultants, LLC
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• Lake Jackson Clinic, P.a.
• Lake Jackson Dental Care P.a.
• Lake Jackson Dialysis and Kidney Center, LTD, LLP
• Lake Jackson Endoscopy Center, LP.
• Lake Jackson Family Dentistry PLLC
• Lake Jackson Imaging Center
• Lake Jackson Operations, LLC
• Lake Jackson Oral and Maxillofacial Surgery, PLLC

• Land Ambulance in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Land Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; 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.