Active NPI
Texas Em-1 Medical Services, PA
- Nurse Practitioner
- Weslaco, TX
National Provider Identifier
1780960328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- TEXAS EM-1 MEDICAL SERVICES, PA
- Practice address
- 1401 E 8TH St
Weslaco, TX 78596-6640 - Phone
- (956) 969-5300
- NPI assigned
- Oct 27, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- William C Jernberg, MD
- Title
- Owner
- Phone
- (214) 712-2000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | Primary |
Addresses
Primary practice location
1401 E 8TH St
Weslaco, TX 78596-6640
Mailing address
1717 Main St
Suite 5200
Dallas, TX 75201-4612
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319673600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1319673600000",
"number": "1780960328",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 E 8TH ST",
"city": "WESLACO",
"state": "TX",
"postal_code": "785966640",
"telephone_number": "956-969-5300"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TEXAS EM-1 MEDICAL SERVICES, PA",
"organizational_subpart": "NO",
"enumeration_date": "2011-10-27",
"last_updated": "2011-10-27",
"status": "A",
"authorized_official_last_name": "JERNBERG",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "214-712-2000",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weslaco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; 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.