Mary Michelle Teeter, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

Q5359 Issued in TX

Practice address

2400 N Interstate Highway 35 E
Waxahachie, TX 75165-5240

Phone

(469) 843-4000

NPI assigned

May 1, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Michelle Bundren Former name

Medicare fee-for-service enrollment

Enrolled in TX, OK2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Century Integrated Partners, IncGroup PAC ID 6406151703, 330 clinicians

Ies ER Oklahoma LLCGroup PAC ID 5395234678, 135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center- Waxahachie Hospital, Waxahachie, TX, CCN 450372
• Saint Francis Hospital South, LLC Hospital, Tulsa, OK, CCN 370218
• Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091

Merit-based Incentive Payment System (MIPS)

Final score

99.43 of 100Reported as group

Quality

93.73

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations (25 of 32)

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Century Integrated Partners, Inc

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1447615711
  Medicare reassignment Care Compare group NPD
• Ies ER Oklahoma LLC

  • Emergency Medicine Physician
  • Tulsa, OK
  • NPI 1447148093
  Medicare reassignment Care Compare group NPD
• Integrative Emergency Services Physician Group-Houston PLLC

  • Emergency Medicine Physician
  • Pasadena, TX
  • NPI 1801458708
  Medicare reassignment NPD
• Scott & White Hospital - Taylor

  • Emergency Medicine Physician
  • Taylor, TX
  • NPI 1659366557
  NPD
• Scott & White Hospital - Taylor

  • Nurse Practitioner
  • Taylor, TX
  • NPI 1659548568
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baylor Medical Center at Waxahachie

  • General Acute Care Hospital
  • Waxahachie, TX
  • NPI 1265430177
  Care Compare affiliation
• Saint Francis Hospital South LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1376561944
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1003039488
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1144228487
  Care Compare affiliation

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1184069361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 N INTERSTATE HIGHWAY 35 E",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "469-843-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N INTERSTATE HIGHWAY 35 E",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751655240",
            "telephone_number": "469-843-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEETER",
        "first_name": "MARY",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-01",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q5359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BUNDREN",
            "middle_name": "MICHELLE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alicia Ann Sward, LCSW
• Julia Taggart-Fowler, COTA
• Rickeya Tatum-Walters
• Lisa G Taylor, RN, CNS, FNP
• Victoria Taylor, LPC, NCC
• Texas Anesthesia & Pain Management Institute, P.a
• Texas Em-1 Medical Services, PA
• Texas Eye and Cataract
• Texas Health Surgery Center Waxahachie, LLC
• Texas Sleep Diagnostics and Therapeutics LLC

• Emergency Medicine Physician in Waxahachie, TX
• Providers in Waxahachie, 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 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.