Individual provider Active NPI

Jeffrey Lynn Teeter, D.O.

  • Family Medicine Physician
  • Jefferson City, MO
National Provider Identifier
1215343769
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2017011936 Issued in MO
Practice address
3121 Emerald LN Ste 800
Jefferson City, MO 65109-6843
Phone
(573) 614-7022
Fax
(573) 635-5899
NPI assigned
Jul 5, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2017011936 MO Primary

Addresses

Primary practice location

3121 Emerald LN Ste 800
Jefferson City, MO 65109-6843

Mailing address

345 Miracle Strip Pkwy SW
Fort Walton Beach, FL 32548-5210
Phone (850) 244-3211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250620002475 MO Practitioner - General Practice 2567785280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Arizona College of Osteopathic Medicine Mid Western University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bothwell Regional Health CenterGroup PAC ID 6103714126, 109 clinicians

Practice addresses (Care Compare)

601 E 14TH St
Bothwell Regional Health Center
Sedalia, MO 65301-5972
Phone (660) 826-8833

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.5 of 100Reported as group
Quality
53.06
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2017011936MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bothwell Regional Health Center CurrentSince May 16, 2025 Accepting new patients
Bothwell Regional Health Center Family Medicine CurrentSince May 16, 2025 Accepting new patients
Gulf Coast Immediate Care Center Inc. PastSince Jan 18, 1999 Accepting new patients

Locations

601 E 14th St
Sedalia, MO 65301
Phone (660) 826-8833

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8204/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1404518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1215343769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 MIRACLE STRIP PKWY SW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485210",
            "telephone_number": "850-244-3211",
            "fax_number": "850-243-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 EMERALD LN STE 800",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651096843",
            "telephone_number": "573-614-7022",
            "fax_number": "573-635-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEETER",
        "first_name": "JEFFREY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-05",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2017011936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.