Individual provider Active NPI

Molly Brynjulson, NNP-BC

  • Neonatal Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1649813197
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
CP001663 Issued in SD
Practice address
1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone
(605) 328-3000
NPI assigned
Oct 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X CP001663 SD Primary

Addresses

Primary practice location

1305 W 18TH St
Sioux Falls, SD 57105-0401

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20211102001272 SD Practitioner - Nurse Practitioner 6103214622 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center CurrentSince Aug 1, 2021 Accepting new patients
Sanford Medical Center CurrentSince Aug 1, 2021 Accepting new patients

Locations

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1649813197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W 18TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050401",
            "telephone_number": "605-328-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYNJULSON",
        "first_name": "MOLLY",
        "credential": "NNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "SD",
            "license": "CP001663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.