NPIMap

Individual provider Active NPI

Jennifer Marie Teeter, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Jeffersonville, IN
National Provider Identifier
1497075410
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
02005701A Issued in IN
Practice address
1220 Spring St
Jeffersonville, IN 47130-3704
Phone
(812) 282-8494
Fax
(812) 288-4481
NPI assigned
Jun 2, 2010
Last updated
Apr 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 250143 NY
Family Medicine Physician 207Q00000X 02005701A IN
Sports Medicine (Family Medicine) Physician 207QS0010X 250143 NY
Sports Medicine (Family Medicine) Physician 207QS0010X 02005701A IN Primary

Addresses

Primary practice location

1220 Spring St
Jeffersonville, IN 47130-3704

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 559-9337

Other identifiers 2

IdentifierTypeStateIssuer
196290270OtherINMEDICARE
300034743MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191015002478 IN Practitioner - Sports MedicinePractitioner - Family Practice 8022132208 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians
New Horizons Physical Therapy Limited PartnershipGroup PAC ID 4183641608, 77 clinicians

Practice addresses (Care Compare)

1461 N Gardner St
Scottsburg, IN 47170-7751
Phone (502) 584-2029

2125 State St
New Albany, IN 47150-4972

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Clark Physician Practices, LLC Family Medicine CurrentSince Sep 3, 2019 Accepting new patients
Community Medical Associates, Inc. Family Medicine CurrentSince Apr 1, 2024 Accepting new patients
Community Medical Associates, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Community Medical Associates, Inc. Past Accepting new patients

Locations

11500 Highway 62
Charlestown, IN 47111
Phone (812) 256-0700

2051 Clevidence Blvd
Clarksville, IN 47129
Phone (812) 280-6650

1220 Spring St
Jeffersonvlle, IN 47130
Phone (812) 282-8494

1806 E 10th St
Jeffersonvlle, IN 47130
Phone (812) 285-5923

1373 E State Road 62
#6F
Madison, IN 47250
Phone (502) 629-7181

1461 N Gardner St
Scottsburg, IN 47170
Phone (812) 282-8494

Interoperability endpoints

  • Direct secure messaging: jteeter280574@direct.nortonhealthcare.org

Organizations & group practices 5

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

Hospital & facility affiliations 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1497075410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-559-9337",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 SPRING ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303704",
            "telephone_number": "812-282-8494",
            "fax_number": "812-288-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEETER",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "250143",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02005701A",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NY",
            "license": "250143",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IN",
            "license": "02005701A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "196290270",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300034743",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.