NPIMap

Organization Active NPI

Texas Em-1 Medical Services, PA

  • Emergency Medicine Physician
  • Trophy Club, TX
National Provider Identifier
1730257643
Registry record updated Sep 2, 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
2850 E. State Highway 114
Trophy Club, TX 76262
Phone
(682) 831-1700
Fax
(214) 712-2487
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2009

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

2850 E. State Highway 114
Trophy Club, TX 76262

Mailing address

1717 Main St
Suite 5200
Dallas, TX 75201-4612
Phone (214) 712-2000

Other identifiers 2

IdentifierTypeStateIssuer
1324175MedicaidTX
DO2378OtherTXRAILROAD

National Provider Directory

National Provider Directory
Tax ID family
TX Em1 Med17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251849600000",
    "number": "1730257643",
    "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": "2850 E. STATE HIGHWAY 114",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "76262",
            "telephone_number": "682-831-1700",
            "fax_number": "214-712-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS EM-1 MEDICAL SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2009-09-02",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1324175",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "DO2378",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trophy Club, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; 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.