Jon R Teegardin, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN227482 Issued in GA

Practice address

331 Somers LN
Tifton, GA 31794-1894

Phone

(229) 539-2210

NPI assigned

Sep 11, 2018

Sex

Male

Sole proprietor

Yes

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.

• Chronic Disease Management of Georgia, LLC

  • Physical Medicine & Rehabilitation Physician
  • Monroe, GA
  • NPI 1699300939

  GA

  Medicare reassignment NPD
• Community Primary Care of Georgia LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Gray, GA
  • NPI 1336492511

  GA

  Medicare reassignment NPD
• Neurology, Neurosurgery, and Spine Clinic of South Georgia

  • Specialist
  • Valdosta, GA
  • NPI 1184781262

  GA

  Medicare reassignment NPD
• Transitional Care Physicians of Georgia PC

  • Specialist
  • Monroe, GA
  • NPI 1619317542

  GA

  Medicare reassignment NPD
• Optimus Diagnostics LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Macon, GA
  • NPI 1144609876
  NPD

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 7, 2024.

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1669955134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 SOMERS LN",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 SOMERS LN",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941894",
            "telephone_number": "229-539-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEEGARDIN",
        "first_name": "JON",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-11",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "RN227482",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN227482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry Lee Taylor Jr., NP
• Rita P Taylor, FNP
• Troy Taylor, PA
• Arslan Tayyab, MBBS
• Ted a McElroy OD, PC
• Margaret Grace Testerman, PHARMD
• The Conner Group for Pediatric Therapies, LLC
• The Lymphedema Center, LLC
• The Orthopedic Spine Center
• The Therapy House Chiropractic & Wellness LLC

• All providers in Tifton, GA
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.