Molly Jane Malmstrom, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

10116 Issued in MN

Practice address

111 W Vernon Ave
Fergus Falls, MN 56537-2741

Phone

(218) 739-2221

NPI assigned

Apr 10, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/

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.

• Lake Region Healthcare Corporation

  • Critical Access Hospital
  • Elbow Lake, MN
  • NPI 1407838329
  Medicare reassignment
• Lake Region Healthcare Corporation

  • General Acute Care Hospital
  • Fergus Falls, MN
  • NPI 1093713372
  NPD
• Lake Region Healthcare Corporation

  • Chiropractor
  • Fergus Falls, MN
  • NPI 1265148480
  NPD
• Lake Region Healthcare Corporation

  • Critical Access Hospital
  • Fergus Falls, MN
  • NPI 1285525436
  NPD
• Lake Region Healthcare Corporation

  • Durable Medical Equipment & Medical Supplies
  • Fergus Falls, MN
  • NPI 1942191119
  NPD

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1922793553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31183 180TH ST",
            "city": "UNDERWOOD",
            "state": "MN",
            "postal_code": "565869523",
            "telephone_number": "218-405-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W VERNON AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372741",
            "telephone_number": "218-739-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALMSTROM",
        "first_name": "MOLLY",
        "middle_name": "JANE",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "10116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashlyn Marie Ma, PHARMD
• Jayme M Mace, D.M.D
• David Jerome Mach, DO
• Lane Marie Magnusson, RN PHN
• Susan Margaret Mahon, RN
• Steven Lee Manning, MD
• Michael Manu
• Corina Anette Mark, PA
• Jeannette Renae Marlen
• Helen Christine Martin

• Pediatric Nurse Practitioner in Fergus Falls, MN
• Providers in Fergus Falls, MN by specialty
• Pediatric Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.