NPIMap

Organization Active NPI

Emerge Medstaffing LLC

  • Emergency Medicine Physician
  • Chicago Heights, IL
National Provider Identifier
1780167841
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EMERGE MEDSTAFFING LLC
Practice address
30 E 15TH St
Chicago Heights, IL 60411-3459
Phone
(312) 206-1064
Fax
(708) 991-2630
NPI assigned
Sep 13, 2018
Last updated
Sep 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Authorized official

Name
Richard Watson, MDNPI 1962472886
Title
President
Phone
(312) 206-1064

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

30 E 15TH St
Chicago Heights, IL 60411-3459

Mailing address

PO Box 786
Flossmoor, IL 60422-0786
Phone (312) 206-1064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181105001875 IL Part B Supplier - Clinic/Group Practice 8123371341 Receives reassigned benefits from 28 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Frankfort, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 28

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 28

NPI Registry JSON

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536796800000",
    "number": "1780167841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 786",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604220786",
            "telephone_number": "312-206-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 15TH ST",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113459",
            "telephone_number": "312-206-1064",
            "fax_number": "708-991-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGE MEDSTAFFING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-13",
        "last_updated": "2018-09-13",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-206-1064",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.