Samantha Rose Teeter, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9112809 Issued in FL

Practice address

4268 Oldfield Crossing Dr
Jacksonville, FL 32223-7898

Phone

(607) 426-1880

NPI assigned

May 1, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Physician Assistant

Practice roles

Locations

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.

• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1508817529

  Physician Assistant

  Medicare reassignment NPD (past)
• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1013160704
  NPD
• Baptist Primary Care Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1790086593
  NPD

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1982269361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4268 OLDFIELD CROSSING DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322237898",
            "telephone_number": "607-426-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4268 OLDFIELD CROSSING DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322237898",
            "telephone_number": "607-426-1880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "322504368",
            "country_code": "US",
            "telephone_number": "904-249-0335",
            "fax_number": "904-249-0042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEETER",
        "first_name": "SAMANTHA",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-01",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Louise Teano
• Renee Marie Tebon, PA-C
• Angelito B Tecson, MD
• Teekares Home Care Services LLC
• Lauren Kristi Teele, CRNA
• Stephen Teeters, D.C.
• Melissa Quinn Teferra, LCSW
• Allison Teger, LMHC
• Tehc, LLC
• Katelyn Teixeira

• Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; 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.