Individual provider Active NPI

Emily Rose Temple-Wood, DO

  • Family Medicine Physician
  • Montevideo, MN
National Provider Identifier
1992334577
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
75259 Issued in MN
Practice address
824 N 11TH St
Montevideo, MN 56265-1629
Phone
(320) 269-8877
NPI assigned
Apr 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.162692 IL
Family Medicine Physician 207Q00000X 75259 MN Primary

Addresses

Primary practice location

824 N 11TH St
Montevideo, MN 56265-1629

Mailing address

1775 Ballard Rd
Park Ridge, IL 60068-1005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231127000364 MN Practitioner - Family Practice 4183072507 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
CCM HealthGroup PAC ID 4284539453, 69 clinicians

Practice addresses (Care Compare)

824 N 11TH St
Montevideo, MN 56265-1629
Phone (320) 269-8877

Hospital & facility affiliations

  • Chippewa County Hospital Hospital, Montevideo, MN, CCN 241325
  • Luther Haven Nursing home, Montevideo, MN, CCN 245259

Merit-based Incentive Payment System (MIPS)

Final score
89.17 of 100Reported as group
Quality
96.66
Promoting interoperability
100
Improvement activities
40
Cost
67.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036.162692ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CCM Health CurrentSince Oct 9, 2023 Accepting new patients
CCM Health CurrentSince Oct 9, 2023 Accepting new patients
CCM Health Past Accepting new patients
CCM Health Past Accepting new patients

Locations

1401 Nwakama St
Ste 100
Marshall, MN 56258
Phone (320) 269-8877

824 N 11th St
Montevideo, MN 56265
Phone (320) 269-8877

Interoperability endpoints

  • Direct secure messaging: etemplewood739894@direct.centracare.com

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 3

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": "1586044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1992334577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 BALLARD RD",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 N 11TH ST",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "562651629",
            "telephone_number": "320-269-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMPLE-WOOD",
        "first_name": "EMILY",
        "middle_name": "ROSE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-05",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.162692",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "75259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montevideo, MN

Sources for this page

Verify at the official NPI Registry.