Individual provider Active NPI

Marily Modesto, APRN, FNP-C

  • Nurse Practitioner
  • Midland, TX
National Provider Identifier
1225991789
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1218347 Issued in TX
Practice address
407 Kent St
Midland, TX 79701-5858
Phone
(432) 687-2273
NPI assigned
Dec 3, 2025
Last updated
Dec 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1218347 TX Primary

Addresses

Primary practice location

407 Kent St
Midland, TX 79701-5858

Mailing address

1407 Alamosa St
Odessa, TX 79763-2413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20251220000431 TX Practitioner - Nurse Practitioner 6204321870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Slater-Delk Medical, PLLCGroup PAC ID 3476875790, 33 clinicians

Practice addresses (Care Compare)

407 Kent St
Midland, TX 79701-5858
Phone (432) 687-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1218347TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Slater-Delk Medical, PLLC CurrentSince Dec 1, 2025 Accepting new patients

Locations

3101 S 27th St
Abilene, TX 79605
Phone (325) 695-5440

4009 Ridgemont Dr
Abilene, TX 79606
Phone (325) 232-8830

2602 S Gregg St
Ste 6
Big Spring, TX 79720
Phone (432) 315-2077

407 Kent St
Midland, TX 79701
Phone (432) 687-2273

4400 N Midland Dr
Midland, TX 79707
Phone (432) 242-7426

4400 N Midland Dr
Ste 406A
Midland, TX 79707
Phone (432) 704-5661

3952 E 42nd St
Ste Z
Odessa, TX 79762
Phone (432) 272-0633

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1764720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1225991789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 ALAMOSA ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797632413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 KENT ST",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797015858",
            "telephone_number": "432-687-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODESTO",
        "first_name": "MARILY",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-03",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1218347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

Verify at the official NPI Registry.