New Jersey-Pennsylvania Em- I Medical Services PC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

NEW JERSEY-PENNSYLVANIA EM- I MEDICAL SERVICES PC

Practice address

965 Shamrock LN
Corry, PA 16407-9121

Phone

(814) 664-4641

NPI assigned

Mar 11, 2014

Organization subpart

No

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

Authorized official

Name

Russ Harris, MD

Title

President

Phone

(469) 401-2386

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395273600000",
    "number": "1700202082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13737 NOEL RD",
            "address_2": "SUITE 1600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752401331",
            "telephone_number": "469-401-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 SHAMROCK LN",
            "city": "CORRY",
            "state": "PA",
            "postal_code": "164079121",
            "telephone_number": "814-664-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY-PENNSYLVANIA EM- I MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-11",
        "last_updated": "2014-03-20",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "RUSS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-401-2386",
        "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": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; 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.