Active NPI
Jeb S Teichman, MD
- Pediatrics Physician
- Jeffersonville, IN
National Provider Identifier
1487699732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01038322
- Practice address
- 207 Sparks Avenue
Ste 403
Jeffersonville, IN 47130 - Phone
- (812) 288-9141
- Fax
- (812) 288-1023
- NPI assigned
- Jun 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 24779 | KY | |
| Pediatrics Physician | 208000000X | 01038322 | IN | Primary |
Addresses
Primary practice location
207 Sparks Avenue
Ste 403
Jeffersonville, IN 47130
Mailing address
207 Sparks Ave
Ste 403
Jeffersonville, IN 47130-3739
Phone (812) 288-9141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01038322 | IN | MD | Pediatrics Physician |
| 24779 | KY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487699732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 SPARKS AVE",
"address_2": "STE 403",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471303739",
"telephone_number": "812-288-9141",
"fax_number": "812-288-1023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 SPARKS AVENUE",
"address_2": "STE 403",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "47130",
"telephone_number": "812-288-9141",
"fax_number": "812-288-1023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEICHMAN",
"first_name": "JEB",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KY",
"license": "24779",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01038322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jeffersonville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.