Texas Em-1 Medical Services PA

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

TEXAS EM-1 MEDICAL SERVICES PA

Practice address

401 W Campbell Rd
Richardson, TX 75080-3416

Phone

(972) 498-4777

NPI assigned

Nov 24, 2006

Organization subpart

No

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

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235001600000",
    "number": "1821164781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 MAIN ST 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": "401 W CAMPBELL RD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803416",
            "telephone_number": "972-498-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS EM-1 MEDICAL SERVICES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2009-02-19",
        "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": "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": "144091910",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in Richardson, TX
• Providers in Richardson, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.