Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jackson Tyler Teboe, FNP-C

Individual provider Family Nurse Practitioner · NPI 1548954951

Mr. Jackson Tyler Teboe, FNP-C is a Nurse Practitioner in Jamestown, New York. Qualified in 2022, 4 years ago. Practices with Great Lakes Physician Practice PC, a 143-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2023
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

207 Foote Ave
Jamestown, NY 14701-7077
Phone: (716) 640-2201
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 351226 (NY)

Record details

NPI number1548954951
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedJune 7, 2023
Last updated in NPPESJune 2, 2024
Certification dateJune 2, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Great Lakes Physician Practice Pc — 143 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Jamestown