Matthew Tembrock

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10472 Issued in MN

Practice address

251 County Road 120
Suite a
Saint Cloud, MN 56303-4872

Phone

(320) 259-5429

Fax

(320) 240-8905

NPI assigned

May 16, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Blue Stone Therapy Inc.

  • Physical Medicine & Rehabilitation Physician
  • Urbandale, IA
  • NPI 1932797297

  MN

  Medicare reassignment NPD

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1669829164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 COUNTY ROAD 120",
            "address_2": "SUITE A",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034872",
            "telephone_number": "320-259-5429",
            "fax_number": "320-240-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 COUNTY ROAD 120",
            "address_2": "SUITE A",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034872",
            "telephone_number": "320-259-5429",
            "fax_number": "320-240-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMBROCK",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-16",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305210154",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0064-0032705",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Norma J Taylor, PSYD
• Sheila Taylor, RN
• Christina Teboh
• Sara A Teig, LCSW
• Teleoptometric Service, P.C.
• Paul Thomas Tembrock, PT
• Sue Tembrock, OTR/L
• Kristen Ashley Templeton
• Rhonda Lee Tepley
• Frances Tepolt, MD

• Physical Therapist in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.