FAIR ACRES EMERGENCY PHYSICIANS, PLLC (NPI# 1093187817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093187817 |
| Entity Type | Organization |
| Organization Name | FAIR ACRES EMERGENCY PHYSICIANS, PLLC |
| Practice Address |
1650 W College St Grapevine TX 76051-3565 |
| Mailing Address |
Po Box 98939 Las Vegas NV 89193-8684 |
| Practice Telephone | 4694012386 |
| Mailing Telephone | 4694012386 |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2015-11-04 |
| Authorized Official Name | WILLIAM C JERNBERG (OFFICER) |
| Authorized Official Telephone | 4694012386 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720450547 | Fair Acres Emergency Physicians, Pllc | Physician Assistant | 4343 N Josey Ln, Carrollton, TX 75010-4603 | 2015-10-21 |
| 1386016103 | Fair Acres Emergency Physicians, Pllc | Physician Assistant | 5201 Harry Hines Blvd, Dallas, TX 75235-7708 | 2015-10-21 |
| 1114398922 | Fair Acres Emergency Physicians, Pllc | Physician Assistant | 2300 Marie Curie Dr, Garland, TX 75042-5706 | 2015-10-20 |
| 1851762660 | Fair Acres Emergency Physicians, Pllc | Physician Assistant | 1405 W Jefferson St, Waxahachie, TX 75165-2231 | 2015-10-20 |
| 1619349446 | Fair Acres Emergency Physicians, Pllc | Physician Assistant | 5252 W University Dr, Mckinney, TX 75071-7822 | 2015-10-20 |
| 1851762603 | Fair Acres Emergency Physicians, Pllc | Physician Assistant | 7100 Oakmont Blvd, Fort Worth, TX 76132-3900 | 2015-10-19 |
| 1255702098 | Fair Acres Emergency Physicians, Pllc | Physician Assistant | 4700 Alliance Blvd, Plano, TX 75093-5323 | 2015-10-19 |
| Street Address |
1650 W COLLEGE ST |
| City | GRAPEVINE |
| State | TX |
| Zip Code | 76051-3565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073511762 | Baylor Regional Medical Center At Grapevine | General Acute Care Hospital | 1650 W College St, Grapevine, TX 76051-3565 | 2005-07-07 |
| 1811521610 | Vicki Bailey | Dietitian, Registered | 1650 W College St, Grapevine, TX 76051-3565 | 2020-03-02 |
| 1407493570 | Amy Fry | Nurse Practitioner | 1650 W College St, Grapevine, TX 76051-3565 | 2019-12-07 |
| 1063988459 | Nicole Aschenbrenner | Nurse Practitioner | 1650 W College St, Grapevine, TX 76051-3565 | 2018-10-23 |
| 1316467186 | Questcare Pulmonary Consultants Pllc | Internal Medicine | 1650 W College St, Grapevine, TX 76051-3565 | 2017-06-22 |
| 1093178360 | Jacquelyn Larussa | Emergency Medicine | 1650 W College St, Grapevine, TX 76051 | 2016-04-03 |
| 1326401951 | Baylor Regional Medical Center At Grapevine | Rehabilitation Unit | 1650 W College St, Grapevine, TX 76051-3565 | 2016-03-31 |
| 1912389958 | Cynthia Kloske | Speech-Language Pathologist | 1650 W College St, Grapevine, TX 76051-3565 | 2015-06-26 |
| 1710377791 | Shabaz Khan, Pllc | Internal Medicine | 1650 W College St, Grapevine, TX 76051-3565 | 2015-01-29 |
| 1467872671 | Jason Darrell Miller | Physical Medicine & Rehabilitation | 1650 W College St, Grapevine, TX 76051-3565 | 2014-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881227346 | Jeffrey Joseph Cervenka | Physical Therapist | 2421 Ira E Woods Ave #101, Grapevine, TX 76051 | 2020-02-12 |
| 1871137562 | Karen Lorince | Counselor | 2409 N. Support Road, Grapevine, TX 76051 | 2019-11-05 |
| 1548733785 | Jessica Thorman Johnson | Dietitian, Registered | 1056 Texan Trail (fortis Bmi), Grapevine, TX 76051 | 2019-01-10 |
| 1164928958 | Kristen Diou | Counselor | 913 S Church St Ste 103, Grapevine, TX 76051 | 2018-04-02 |
| 1356860597 | Anissa Singratanakul D.m.d, Pllc | Dentist | 1231 William D Tate Suite 400, Grapevine, TX 76051 | 2017-09-19 |
| 1033637665 | James Abraham Thomas | Pharmacy | 1601 W. State Hwy 114, Grapevine, TX 76051 | 2017-09-04 |
| 1437606563 | D'anna Sims | Counselor | 2451 Stone Myers Parkway, #100, Grapevine, TX 76051 | 2016-09-07 |
| 1477006369 | Melinda Jeanne Mashburn | Nurse Practitioner | 1600 West College St., Suite 60, Grapevine, TX 76051 | 2016-07-27 |
| 1437506623 | Allcare Physicians Group | Registered Nurse | 1111 S Main St Ste 119, Grapevine, TX 76051 | 2016-05-18 |
| 1790141745 | Colwick Counseling | Clinic/Center | 1400 W. Northwest Highway Suite 260, Grapevine, TX 76051 | 2016-01-06 |
| Find all providers in zip 76051 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932265774 | David S Diamond | Emergency Medicine | 1650 West College Ave, Baylor Medical Center Grapevine, Grapevine, TX 76051 | 2006-12-28 |
| 1649256421 | John Myers | Emergency Medicine | 3000 Grapevine Mills Pkwy Ste 329-20, Grapevine, TX 76051-2008 | 2005-12-22 |
| 1093178360 | Jacquelyn Larussa | Emergency Medicine | 1650 W College St, Grapevine, TX 76051 | 2016-04-03 |
| 1992094247 | Amanda Rose Verdeyen | Emergency Medicine | 1650 W College St, Grapevine, TX 76051-3565 | 2011-04-06 |
| 1417175209 | Pedro Juan Loredo IIi | Emergency Medicine | 220 N Park Blvd Ste 100, Grapevine, TX 76051-6900 | 2007-04-24 |
| 1295879955 | Nick Frank Musso Jr. | Emergency Medicine | 1650 W College St, Grapevine, TX 76051-3565 | 2007-02-16 |
| 1255471934 | Roger C Sessions | Emergency Medicine | 1650 W College St, Grapevine, TX 76051-3565 | 2007-02-08 |
| 1790880672 | Alexander Hammond Hatcher | Emergency Medicine | 1650 W College St, Grapevine, TX 76051-3565 | 2006-09-14 |
| 1285673483 | Ronald Jensen | Emergency Medicine | 1650 W College St, Grapevine, TX 76051-3565 | 2006-06-05 |
| 1780621250 | Texas Em-1 Medical Services, Pa | Emergency Medicine | 1650 W College St, Grapevine, TX 76051-3565 | 2006-06-01 |
| Find all providers in GRAPEVINE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.