Bethany Templin, AGPCNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

4704278245 Issued in MI

Practice address

2300 Biddle Ave Ste 100
Wyandotte, MI 48192-4650

Phone

(347) 250-2516

NPI assigned

Jun 30, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Master of Science

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bethany.templin.1@8940.direct.athenahealth.com
• Direct secure messaging: btemplin364951@direct.hfhs.org
• FHIR API: https://api.platform.athenahealth.com/8940/brand/1/csg/1/fhir/r4

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.

• South Valley Internal Medicine, P.C.

  • Internal Medicine Physician
  • Trenton, MI
  • NPI 1215272596
  Medicare reassignment NPD

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1609259373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 21ST ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 BIDDLE AVE STE 100",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924650",
            "telephone_number": "347-250-2516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMPLIN",
        "first_name": "BETHANY",
        "name_prefix": "Mrs.",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-30",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704278245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "btemplin364951@direct.hfhs.org",
            "affiliation": "Y",
            "affiliationName": "Henry Ford Wyandotte Hospital",
            "address_1": "2300 Biddle Ave Ste 100",
            "city": "Wyandotte",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481924650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Wyandotte, MI
• Providers in Wyandotte, MI by specialty
• Primary Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.