Individual provider Active NPI

Molly Jean Soeby, MT, SC (ASCP), MPA

  • Medical Technologist
  • Grand Forks, ND
National Provider Identifier
1932559564
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical TechnologistTaxonomy code 246QM0706X
License
90-0456-I Issued in ND
Practice address
151 S 4TH St
Ste 302
Grand Forks, ND 58201-4715
Phone
(701) 780-8229
NPI assigned
Jun 14, 2016
Last updated
Jun 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Technologist 246QM0706X 90-0456-I ND Primary

Addresses

Primary practice location

151 S 4TH St
Ste 302
Grand Forks, ND 58201-4715

Mailing address

718 Oak St
Grand Forks, ND 58201-4460
Phone (218) 230-0070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
90-0456-INDMDMedical Technologist

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": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1932559564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 OAK ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014460",
            "telephone_number": "218-230-0070",
            "fax_number": "800-958-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 S 4TH ST",
            "address_2": "STE 302",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014715",
            "telephone_number": "701-780-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOEBY",
        "first_name": "MOLLY",
        "middle_name": "JEAN",
        "credential": "MT, SC (ASCP), MPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": "ND",
            "license": "90-0456-I",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.