Modern Esthetics & Dermatology, PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

MODERN ESTHETICS & DERMATOLOGY, PLLC

Practice address

514 Thompson St Ste 1
Bottineau, ND 58318-1238

Phone

(701) 201-0636

NPI assigned

Apr 18, 2022

Last updated

Jan 17, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Molly Beyer, NPNPI 1417591140

Title

Nurse Practitioner, Owner

Phone

(701) 201-0636

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26296/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Molly Sue Beyer, FNP-C

  • Family Nurse Practitioner
  • Bottineau, ND
  • NPI 1417591140
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737072000000",
    "number": "1952044968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 5TH ST E",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583181402",
            "telephone_number": "701-201-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 THOMPSON ST STE 1",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583181238",
            "telephone_number": "701-201-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN ESTHETICS & DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-18",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A",
        "authorized_official_last_name": "BEYER",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_title_or_position": "NURSE PRACTITIONER, OWNER",
        "authorized_official_telephone_number": "701-201-0636",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Lynn Lorenz
• Michael George Mack, D.C.
• Mark W Pewe (Chiropractic Arts)
• Brenda Marquardt, A.N.P.
• Deeanne McGuire, RN
• Vilma Moncera
• Molly Ann Motschenbacher
• Aimee Nehring
• Peace Garden Multi-District Cooperative (Peace Garden Special Services)
• Kathryn Pfau, M.S.

• Medical Specialty Clinic/Center in Bottineau, ND
• Providers in Bottineau, ND by specialty
• Medical Specialty Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.