Individual provider Active NPI

Jamie Scott Teeter, PA-C

  • Surgical Physician Assistant
  • Tulsa, OK
National Provider Identifier
1689977241
Registry record updated Sep 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
6161 S Yale Ave
Tulsa, OK 74136-1902
Phone
(918) 494-1805
NPI assigned
Dec 20, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

6161 S Yale Ave
Tulsa, OK 74136-1902

Mailing address

PO Box 975471
Dallas, TX 75397-5471
Phone (918) 488-6001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20110210001147 OK Practitioner - Physician Assistant 4688854474 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Radiology PLLCGroup PAC ID 8628332061, 217 clinicians
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians

Practice addresses (Care Compare)

Tulsa, OK 74105
Phone (888) 264-0330

1705 E 19TH St
Tulsa, OK 74104-5410

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2071

Hospital & facility affiliations

  • Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114
  • St John Owasso Hospital, Owasso, OK, CCN 370227
  • Ascension St John Broken Arrow Hospital, Broken Arrow, OK, CCN 370235

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2005OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Radiology PLLC CurrentSince May 13, 2026 Accepting new patients
St. John Physicians, Inc. CurrentSince Jan 13, 2015 Accepting new patients
St. John Physicians, Inc CurrentSince Jan 13, 2015 Accepting new patients

Locations

800 W Boise Cir
Ste 250
Broken Arrow, OK 74012
Phone (918) 994-9250

1021 E Bryan Ave
Sapulpa, OK 74066
Phone (918) 227-1000

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

8131 S Memorial Dr
Tulsa, OK 74133
Phone (918) 252-5114

1717 S Utica Ave
Ste A
Tulsa, OK 74104
Phone (918) 748-1300

1923 S Utica Ave
#5
Tulsa, OK 74104

Organizations & group practices 4

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 4

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": "1292803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1689977241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 975471",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753975471",
            "telephone_number": "918-488-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361902",
            "telephone_number": "918-494-1805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEETER",
        "first_name": "JAMIE",
        "middle_name": "SCOTT",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-20",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.