NPIMap

Organization Active NPI

Texas Em-1 Medical Services, PA

  • Emergency Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1558438192
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
TEXAS EM-1 MEDICAL SERVICES, PA
Practice address
1400 8TH Ave
Fort Worth, TX 76104-4110
Phone
(817) 922-6226
Fax
(214) 712-2487
NPI assigned
Nov 29, 2006
Last updated
Mar 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1400 8TH Ave
Fort Worth, TX 76104-4110

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

Practitioners & affiliated clinicians

Practitioners 12

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": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1558438192",
    "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": "214-712-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044110",
            "telephone_number": "817-922-6226",
            "fax_number": "214-712-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS EM-1 MEDICAL SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-03-24",
        "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": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.