NPIMap

Organization Active NPI

Texas Em-1 Medical Services PA

  • Emergency Medicine Physician
  • Houston, TX
National Provider Identifier
1679648695
Registry record updated Feb 20, 2009
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
1313 Hermann Drive
Houston, TX 77004-7005
Phone
(713) 527-5129
Fax
(214) 712-2487
NPI assigned
Nov 22, 2006
Last updated
Feb 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2009

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

Authorized official

Name
Dr. William C Jernberg, M.D.
Title
President, General Partner
Phone
(214) 712-2448

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

1313 Hermann Drive
Houston, TX 77004-7005

Mailing address

1717 Main St
Ste:5200
Dallas, TX 75201-7365
Phone (214) 712-2448

Other identifiers 1

IdentifierTypeStateIssuer
081343802MedicaidTX

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 43

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 43

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235088000000",
    "number": "1679648695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 MAIN ST",
            "address_2": "STE:5200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752017365",
            "telephone_number": "214-712-2448",
            "fax_number": "214-712-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 HERMANN DRIVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770047005",
            "telephone_number": "713-527-5129",
            "fax_number": "214-712-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS EM-1 MEDICAL SERVICES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2009-02-20",
        "status": "A",
        "authorized_official_last_name": "JERNBERG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT, GENERAL PARTNER",
        "authorized_official_telephone_number": "214-712-2448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081343802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; 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.