JOHN TEMPLETON M.D.
NPI 1043290695
Pediatrics in Asheville, NC
NPI Status: Active since January 19, 2006
Contact Information
40 N MERRIMON AVE STE 117
ASHEVILLE, NC
ZIP 28804
Phone: (828) 348-8232
Fax: (855) 323-6740
- Individual
- Male
- Pediatrics
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About JOHN TEMPLETON
This page provides the complete NPI Profile along with additional information for John Templeton, a pediatrician established in Asheville, North Carolina with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1043290695 assigned on January 2006. The practitioner's primary taxonomy code is 208000000X with license number 200000996 (NC). The provider is registered as an individual and his NPI record was last updated 9 years ago.
- NPI
- 1043290695
- Provider Name
- JOHN TEMPLETON M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 40 N MERRIMON AVE STE 117 ASHEVILLE, NC 28804
- Location Phone
- (828) 348-8232
- Location Fax
- (855) 323-6740
- Mailing Address
- 40 N MERRIMON AVE STE 117 ASHEVILLE, NC 28804
- Mailing Phone
- (828) 348-8232
- Mailing Fax
- (855) 323-6740
- Is Sole Proprietor?
- No
- Enumeration Date
- 01-19-2006
- Last Update Date
- 03-25-2016
- Code Navigator
A pediatrician like John Templeton is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 200000996
- License State
- NC
- Taxonomy Description
- A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | 33115 (SC) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- AmeriHealth Caritas Next Bronze Essential + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Premier + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Signature + No Referrals - HMO
- AmeriHealth Caritas Next Gold Deluxe + No Referrals - HMO
- AmeriHealth Caritas Next Gold Signature + No Referrals - HMO
- AmeriHealth Caritas Next Silver Deluxe + No Referrals - HMO
- AmeriHealth Caritas Next Silver Premier + No Referrals - HMO
- AmeriHealth Caritas Next Silver Signature + No Referrals - HMO
- Bronze First 7500 $25 Generic Drugs - HMO
- Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
- Core Gold 1500 $10 Generic Drugs - HMO
- Core Gold 1500 $10 Generic Drugs Adult Vision & Fitness - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Gold 1500 $15 Generic Drugs - HMO
- Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
- Connect Bronze 5500 Indiv Med Deductible - HMO
- Connect Bronze 6500 Indiv Med Deductible - HMO
- Connect Bronze CMS Standard - HMO
- Connect Gold CMS Standard - HMO
- Connect Silver 3500 Indiv Med Deductible - HMO
- Connect Silver 4400 Indiv Med Deductible - HMO
- Connect Silver CMS Standard - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic 4700 | with Atrium Health - HMO
- Bronze Classic Standard - HMO
- Bronze Classic Standard | with Atrium Health - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Elite + PCP Saver Plus | with Atrium Health - HMO
- Gold Classic Standard - HMO
- Gold Classic Standard | with Atrium Health - HMO
- Gold Elite Saver Plus - HMO
- Gold Elite Saver Plus | with Atrium Health - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Bronze Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| I34896 | MEDICARE UPIN (02) | ||
| NCL371E134 | MEDICARE PIN (08) | NC | |
| Q96000 | MEDICAID (05) | SC | |
| 8912886 | MEDICAID (05) | NC |
Medicare Participation & PECOS Enrollment Status
John Templeton is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 28804 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $83.9
- Minimum New Patient Price $54.12
- Maximum New Patient Price $165.09
- Average New Patient Copayment $20.97
- Minimum New Patient Copayment $13.53
- Maximum New Patient Copayment $41.27
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.94
- Minimum Established Patient Price $17.21
- Maximum Established Patient Price $134.61
- Average Established Patient Copayment $23.98
- Minimum Established Patient Copayment $4.3
- Maximum Established Patient Copayment $33.65
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Documentation of Current Medications in the Medical Record | 96% | 23 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Preventive Care and Screening: Screening for Depression and Follow-Up Plan | 51% | 256 |
| Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 4 | 3 | 2 | 9 | 0 | 6 | 9 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 8 | 3 | 4 | 9 | 0 | 6 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 8 + 3 + 4 + 9 + 0 + 6 + 1 + 8 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1043290695 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1477510592 | MARGARET AVERY WHITE MD Individual | Pediatrics | 40 N MERRIMON AVE STE 117 ASHEVILLE, NC 28804 (828) 348-8232 |
| 1699981977 | MRS. KRISTINA REYNOLDS BEARDSLEY M.D. Individual | Pediatrics | 40 N MERRIMON AVE STE 117 ASHEVILLE, NC 28804 (828) 348-8232 |
| 1497318687 | RACHEL RONGSTAD MIFFLIN MD Individual | Pediatrics | 40 N MERRIMON AVE STE 117 ASHEVILLE, NC 28804 (828) 348-8232 |
| 1225077423 | DR. LAUREN KEELY CARLISLE M.D. Individual | Pediatrics | 40 N MERRIMON AVE STE 117 ASHEVILLE, NC 28804 (828) 348-8232 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1043290695, enumerated in the NPI registry as an "individual" on January 19, 2006
The provider is located at 40 N Merrimon Ave Ste 117 Asheville, Nc 28804 and the phone number is (828) 348-8232
The provider's speciality is Pediatrics with taxonomy code 208000000X
The provider might be accepting Accepts: Aetna CVS Health, AmeriHealth Caritas Next,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $83.9 with an average copayment of $20.97 for new patient appointments. Established patients should expect a typical charge of $95.94 and an average copayment of 23.98. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on January 19, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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